Children and adolescents ages 1–17 who take antipsychotic medications have specific health care needs related to their medications. Please consider the following best practices to help ensure those needs are met. These best practices are based on information from the American Academy for Child and Adolescent Psychiatry (AACAP), the American Psychiatric Association and the Healthcare Effectiveness Data and Information Set (HEDIS®) specifications.
Children on antipsychotic medications need to have received a psychosocial care appointment at least 90 days prior to being prescribed antipsychotic medication or within 30 days of starting an initial antipsychotic prescription, if there is an urgent need for medication.
Psychosocial care is recommended for children and adolescents prescribed antipsychotic medication to treat these conditions:
- Autism spectrum disorders
- Attention-deficit/hyperactivity disorder (ADHD)
- Conduct-related symptoms
- Tourette syndrome
Examples of psychosocial care include:
- Behavioral health services, such as individual and group psychotherapy
- Crisis intervention services
- Peer services
- Partial hospitalization
- Activity therapy, such as music, art or play therapy that isn’t for recreation
- Training and educational services related to care/treatment
Children and adolescents prescribed two or more antipsychotic medications need to have metabolic testing after an initial prescription and then annually while remaining on medications.
Testing needs to include all of the following:
- At least one test for blood glucose or HbA1c
- At least one test for LDL-C or cholesterol
Resources to Help You Care for Members
Here are resources you can use in your care for children on antipsychotic medications:
• Request coordination of care and referrals for members by calling the number on the back of the member’s health plan ID card or searching liveandworkwell.com.
• Find tools and information about behavioral health issues on providerexpress.com > Clinical Resources > Behavioral Health Tool Kit for Medical Providers.
• Get educational information for members on liveandworkwell.com. Use access code “clinician” and select “Mind & Body” at the top of the page to view the topics available.