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Prescribing of Clozapine and Antipsychotic Polypharmacy for Schizophrenia in a Large Medicaid Program.

Psychiatr Serv

June 2017

Dr. Tang, who was a doctoral student at the University of Pittsburgh when this work was conducted, is with RTI International, Research Triangle Park, North Carolina (e-mail: ). Dr. Horvitz-Lennon is with RAND Corporation, Boston. Dr. Gellad is with the U.S. Department of Veterans Affairs Pittsburgh Healthcare System and the Division of General Medicine, University of Pittsburgh, both in Pittsburgh. Dr. Lave and Dr. Donohue are with the Graduate School of Public Health and Dr. Chang is with the Department of Biostatistics, University of Pittsburgh. Dr. Normand is with Harvard Medical School, Boston.

Objective: Underuse of clozapine and overuse of antipsychotic polypharmacy are both indicators of poor quality of care. This study examined variation in prescribing clozapine and antipsychotic polypharmacy across providers, as well as factors associated with these practices.

Methods: Using 2010-2012 Pennsylvania Medicaid data, prescribers were identified if they wrote antipsychotic prescriptions for ten or more nonelderly adult patients with schizophrenia annually.

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