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Use of Multiple Concurrent Antipsychotics in Children & Adolescents

Concurrent use of more than one antipsychotic medication in children and adolescents has increased over time. This increase raises concerns about:

  • Appropriate use
  • Medication management
  • Side effects

Explore the percentage of children and adolescents ages 1 to 17 treated with antipsychotic medications and who were on two or more concurrent antipsychotic medications for at least 90 consecutive days. Lower rates are better.

The purple dashed line represents the median, or middle of all values reported.

This measure reports the percentage of children and adolescents ages 1 to 17 treated with antipsychotic medications and who were on two or more concurrent antipsychotic medications for at least 90 consecutive days during the measurement year.

States voluntarily report on Use of Multiple Concurrent Antipsychotics in Children & Adolescents (APC-CH) as part of the Core Set of Children's Health Care Quality Measures. These data show performance rates for states that voluntarily reported the measure using Child Core Set measure specifications.

The included populations for Child Core Set measures can vary by state. For example, some states report data on certain populations such as those covered under managed care but not those covered under fee-for-service (FFS). This variation in data can affect measure performance and comparisons between states.

Use of Multiple Concurrent Antipsychotics in Children & Adolescents

Source: Mathematica analysis of Medicaid and CHIP Program System (MACPro) reports as of June 3, 2019 for the Child Core Set Federal Fiscal Year (FFY) 2018 reporting cycle; see 2018 Child and Adult Health Care Quality Measures. For more information on Use of Multiple Concurrent Antipsychotics in Children & Adolescents (APC-CH) visit Child Health Care Quality Measures.

Notes:

The following states did not report data to the Centers for Medicare & Medicaid Services (CMS) for this measure: AK, CO, GA, HI, ID, IL, MD, MN, MT, ND, OR, and WI.

The Child Core Set specifications include guidance for calculating this measure using the administrative method.  Unless otherwise specified, the administrative data source is the state’s Medicaid Management Information System (MMIS) and/or data submitted by managed care plans, including behavioral health plans.

Unless otherwise specified:

  • States used Child Core Set specifications, based on National Committee for Quality Assurance (NCQA) 2018 specifications.
  • Denominators are assumed to be the measure-eligible population for states using the administrative method. Some states reported exclusions from the denominator, as noted in the state-specific comments.
  • The measurement period for this measure was January 1, 2017 to October 31, 2017. AZ reported data for FFY 2016.

ADHD = Attention-Deficit/Hyperactivity Disorder; CCO = Coordinated Care Organization; CHIP = Children’s Health Insurance Program; CMS = Centers for Medicare & Medicaid Services; CPT = Current Procedural Terminology; CY = Calendar Year; ED = Emergency Department; EPSDT = Early and Periodic Screening, Diagnostic, and Treatment; EQRO = External Quality Review Organization; FFS = Fee for Service; FFY = Federal Fiscal Year; HEDIS = Healthcare Effectiveness Data and Information Set; HMO = Health Maintenance Organization; ICD = International Classification of Diseases; LOINC = Logical Observation Identifiers Names and Codes; MACPro = Medicaid and CHIP Program System; MCO = Managed Care Organization; MMIS = Medicaid Management Information System; NCQA = National Committee for Quality Assurance; NR = Not Reported; PCCM = Primary Care Case Management; PCP = Primary Care Practitioner.