Antipsychotic Atlas: Medicare Usage of Antipsychotic Medications in Washington State

Antipsychotics medications are powerful tools for managing serious mental health problems such as schizophrenia and psychotic disorders, but these medications can also carry substantial side effects, such as metabolic syndrome, stroke and thromboembolism. Prescribers and patients must balance the large potential benefits against the risk of harm in making clinical decisions, including in cases where these drugs are used for non-psychotic diagnoses.

Researchers at Washington State University in Spokane are currently analyzing Medicare data to track use of antipsychotics among Medicare patients in 2010 and in the year that followed, to determine side effects, and differences in who uses the medication. The investigation will describe how many individuals are using antipsychotics at high doses, doses too low to be effective, ending use, switching prescriptions, or combining antipsychotics with other psychiatric medications. Further, they will probe sociodemographic and geographic information (age, gender, insurance coverage, location) to better understand who is using antipsychotics, and match that data with diagnoses and drug prescription.  

The end goal will be a map showing providers where antipsychotics are used for psychotic conditions, where these drugs are used for other diagnoses, where patients are and are not adhering to medications – at a county level. Clinicians can use these findings to help identify interventions, including strategies to help patients stay on effective medications. This work is part of a broader national effort to reduce costs and improve outcomes for some of the higher-cost, higher-acuity patients in Washington and nationally, including those with schizophrenia, dementia and bipolar disorder.