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Characteristics of Medicaid Recipients Receiving Persistent Antipsychotic Polypharmacy

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Abstract

Antipsychotic polypharmacy (APP) is a common strategy despite guidelines advising against this practice. This article seeks to quantify the prevalence and correlates of APP using Medicaid Analytic eXtract files from 2003 to 2004. Nineteen percent of Medicaid recipients who received an antipsychotic were treated with APP. Individuals who received APP were more likely to be white, male, disabled, between the ages of 18–29, diagnosed with a psychotic disorder, and diagnosed with a higher number of psychiatric conditions. Geographic variation in APP rates was also observed. Quality improvement initiatives may help reduce APP for medically vulnerable patients.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 80 Jesse Hill Jr Dr SE, Atlanta, GA, 30303, USA

    Robert O. Cotes & David R. Goldsmith

  2. Division of Public Behavioral Health & Justice Policy, Department of Psychiatry & Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA

    Sarah L. Kopelovich

  3. Department of Health Policy and Management, Center for Behavioral Health Policy Studies, Emory University Rollins School of Public Health, Atlanta, GA, USA

    Cathy A. Lally & Benjamin G. Druss

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  1. Robert O. Cotes
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Dr. Cotes has accepted research funding and speaker honorarium from Otsuka Pharmaceuticals, research funding and consultation fees from Alkermes, and research funding from Lundbeck. The remaining authors declare that they have no conflict of interest. All authors certify responsibility for the manuscript.

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Cotes, R.O., Goldsmith, D.R., Kopelovich, S.L. et al. Characteristics of Medicaid Recipients Receiving Persistent Antipsychotic Polypharmacy. Community Ment Health J 54, 699–706 (2018). https://doi.org/10.1007/s10597-017-0183-y

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