Best Practice Guidelines for Prescribing Antipsychotic Medication to Youth

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CE Course Description

The safe and effective use of antipsychotic medications for children and adolescents in the United States is a critical issue in mental health and substance use treatment.  The goal of this intermediate level continuing education course, developed using information from Substance Abuse and Mental Health Services Administration (SAMSHA), is to provide centralized information that articulates the scope of available systems‐level strategies to promote antipsychotic best practice prescribing for youth. The course material provides background information on antipsychotic prescribing and use among young people and intends to inform public and private sector decision‐makers, prescribing clinicians, service providers, and youth and their families of the best available evidence and corresponding recommendations.

Author: Substance Abuse and Mental Health Services Administration

CE Course Objectives

1. Evaluate the experiences of families and youth who are prescribed antipsychotic medications, national trends in antipsychotic medication prescribing over time, and the safety and efficacy of antipsychotic medication treatment.
2. Describe the six key principles for system-level strategies to promote antipsychotic medication oversight and best practice prescribing for youth.
3. Identify ways to engage youth and families in direct care, to improve organizational barriers and policy and to engage prescribing clinicians in making evidence-based decisions.
4. Determine how to best consider the needs of special populations at every stage of development, implementation, and evaluation of strategies for evidence‐based antipsychotic prescribing.
5. Summarize specific strategies to promote antipsychotic medication oversight and best practice prescribing.
6. Identify promising practices regarding prior authorization of antipsychotic medication for youth, the use of drug utilization reviews, elective psychiatric consultation, and shared decision-making.
7. Analyze the connection between antipsychotic medication treatment and shortages in availability of non‐pharmacological alternatives such as behavioral therapies, psychological therapies, and other psychosocial services.
8. Outline implications for research pertaining to the long‐term safety and efficacy of antipsychotic prescribing and the effectiveness of strategies to promote antipsychotic best practice prescribing.

CE Course Outline

Executive Summary (10 mins)

1. Overview of course objectives and key takeaways.

Part A: Goals of This Guidance (10 mins)

1. Explanation of the course's goals and purpose.

Part B: Background (30 mins)

1. Experiences of Families and Youth (10 mins)
   1. Common challenges faced by families and youth using antipsychotics.
2. Trends in Antipsychotic Prescribing Among Youth (5 mins)
   1. Statistical overview of prescribing trends.
3. Safety and Efficacy of Antipsychotic Medication Treatment (5 mins)
   1. Evidence supporting antipsychotic use in youth.
4. Quality of Prescribing Once Treatment is Initiated (5 mins)
   1. Ensuring safe and effective long-term prescribing practices.
5. Practice Parameters for Antipsychotic Prescribing (5 mins)
   1. Professional guidelines for clinicians.

Part C: A Framework for Strategies to Promote Best Practice Prescribing (15 mins)

1. Introduction to strategic frameworks for improving antipsychotic prescribing.

Part D: Key Principles for Strategies to Promote Best Practice Prescribing (30 mins)

1. Engage Youth and Families (5 mins)
2. Invest in a Multi-Modal Approach (5 mins)
3. Engage Prescribing Clinicians (5 mins)
4. Consider the Unique Needs of Special Populations (5 mins)
5. Coordinate with Other Youth-Serving Systems (5 mins)
6. Sustainable Financing Mechanisms (5 mins)

Part E: Strategies to Promote Antipsychotic Medication Oversight and Best Practices (60 mins)

1. Strategy 1: Prior Authorization and Mandatory Peer Review (10 mins)
2. Strategy 2: Drug Utilization Reviews (5 mins)
3. Strategy 3: Elective Psychiatric Consultation (5 mins)
4. Strategy 4: Shared Decision-Making Tools for Youth and Families (10 mins)
5. Strategy 5: Quality Improvement and Learning Collaboratives (5 mins)
6. Strategy 6: Trauma-Informed and Evidence-Based Systems of Care (10 mins)
7. Strategy 7: Public Reporting and Quality Indicators (5 mins)
8. Strategy 8: Intensive Care Coordination (5 mins)
9. Strategy 9: Multi-Modal Initiatives (5 mins)

Part F: Implications for Research (15 mins)

1. Areas where further research is needed.

Part G: Conclusions (10 mins)

1. Recap of key principles and call to action.

Total Time: 180 minutes (3 hours)
Course Level: Introductory

Course Date: 2019-05-01

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