Evidence-Based Practices for Medicaid Beneficiaries with Schizophrenia and Bipolar Disorder. A. Pharmacologic EBPs for Schizophrenia


Table A.4 summarizes the approaches used to measure the use and continuity of medications for schizophrenia.

TABLE A.4. Measurement of Medication Use and Continuity for Schizophrenia

EBP for Schizophrenia



Use of antipsychotic medication Beneficiaries with at least one claim for antipsychotic Beneficiaries with a schizophrenia diagnosis
Continuity of antipsychotic medication Number of beneficiaries for whom the total days’ supply on all nonoverlapping antipsychotic fills was 80 percent or more of the days since their first fill for an antipsychotic Number of beneficiaries whose first prescription fill for an antipsychotic was more than 90 days away from the end of the study period (December 31, 2007) or their disenrollment from Medicaid.

Medication continuity was measured by examining the ratio of the day’s supply on all antipsychotic prescriptions to the number of days that pass from the initial antipsychotic prescription until the end of the calendar year or disenrollment from Medicaid. Prescription fills for different antipsychotics that covered the same period of time were generally treated as a single prescription for the purpose of counting the number of days of medication supply, unless the overlap was less than 5 days in which case we assumed the beneficiary had filled their next month’s prescription early. Next, we then calculated the number of days that passed from the first dispensing of any antipsychotic until the end of the study period to define the “treatment period.” The sum of days’ supply of antipsychotics is divided by the “treatment period” to calculate the medication possession ratio (Sum of days’ supply of antipsychotics) / (Total days in treatment period). We then created a dichotomous variable that differentiated beneficiaries with low and high medication continuity, with high continuity defined as a possession ratio of 80 percent (Lang et al. 2010).

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