USING MEDICAID CLAIMS DATA TO GENERATE PERSONALIZED HEALTH MESSAGES IN A WEB-BASED SHARED DECISION MAKING TOOL (MYPSYCKES): PATIENT ENDORSEMENT OF INDIVIDUALLY TAILORED VERSUS STANDARDIZED MENTAL HEALTH MEDICATION TREATMENT CONCERNS

Wednesday, October 23, 2013
Key Ballroom Foyer (Hilton Baltimore)
Poster Board # P4-33
Decision Psychology and Shared Decision Making (DEC)

Molly Finnerty, MD1, Elizabeth Austin, MPH1, Qingxian Chen, MS2, Edith Kealey, MSW1, Krithika Rajagopalan, PhD3 and Emily Leckman-Westin, PhD2, (1)New York State Office of Mental Health, New York, NY, (2)New York State Office of Mental Health, Albany, NY, (3)Sunovion Pharmaceuticals Inc., Marlborough, MA
Purpose:  MyPSYCKES is a web-based shared decision making program that is linked to a state Medicaid database. The MyPSYCKES application presents questions about common medication concerns to all patients using the program in preparation for their medication appointment with their doctor. The application also presents personalized health messages and treatment concerns based on the patient’s unique Medicaid quality profile. The purpose of this study is to examine patients’ level of endorsement of treatment concerns for both standard and personalized health messages as part of a shared decision making process.

Method:  MyPSYCKES was implemented in two diverse Medicaid mental health clinics in New York City with a combined census of 471 patients. Patient response data was extracted from the MyPSYCKES data base. Percent of patients endorsing each treatment concern is summarized for 13 standard questions and 1 personalized question (individuals with cardiometabolic conditions, e.g. diabetes, on a higher metabolic impact antipsychotic).

Result:  A total of 204 patients (43%) used the MyPSYCKES application, and of those 188 (92%) completed the treatment concerns questions. Among completers, 72% (n=136) had Medicaid insurance, and 8.8% (n=12) were eligible for and received the personalized health message. Among the 13 standard medication concern questions, the leading concern was whether their medications were helping them (52%), followed by concerns about how their psychiatric medications were affecting their health (37%) and concerns about side effects (32%).  Across all 13 standard questions, the average rate of endorsement for the concerns was 22%.  For the personalized health message 42% of patients who received the message indicated they wanted to discuss this issue with their physician as a goal for their medication appointment that day.

Conclusion:  These data reveal important patterns of concerns for patients taking mental health medications.  Of the 14 questions included, the personalized question linked to individual health status had the second highest endorsement rate, indicating that providing patients with tailored messaging in the context of a shared decision-making application is a promising strategy for promoting patient-centered care.