title: A+KIDS, a web-based antipsychotic registry for North Carolina youths: an alternative to prior authorization.
abstract: OBJECTIVE
  The rise in use of antipsychotics among U.S. children is well documented. Compliance rates with current safety-monitoring guidelines are low. In response, the North Carolina Division of Medical Assistance established the Antipsychotics-Keeping It Documented for Safety (A+KIDS) registry. The initial objectives of the project were to successfully establish a Web-based safety registry and to obtain and evaluate clinical information derived from the registry.
  
  
  METHODS
  In April 2011, A+KIDS began asking prescribers of antipsychotics for children age 12 and under to respond to a set of questions regarding dose, indication, and usage history. Antipsychotic registrations were examined by linking North Carolina Medicaid prescription claims to registry entries. Prescribers were classified into different types, and the number of patients and registrations per prescriber were examined.
  
  
  RESULTS
  In the initial six months, 730 prescribers registered 5,532 patients, 19% below age seven. By month 6 of the registry, 72% of all fills were registered with the program. Top diagnosis groups for registry patients were unspecified mood disorders, autism spectrum disorders, and disruptive behavior disorders. Top target symptoms were aggression (48%), irritability (19%), and impulsivity (11%). Psychosis accounted for 5% of the target symptoms. Twenty-eight percent of children were receiving no form of psychotherapy. Twenty-five percent of all A+KIDS prescribers were responsible for 81% of the registrations.
  
  
  CONCLUSIONS
  The A+KIDS registry initiative has been successful, as measured by rapid uptake, and is providing clinical information not available from claims data alone. Future efforts will allow for detailed examinations of antipsychotic utilization and further safety improvement.
authors.forename: Robert B
authors.initials: RB
authors.lastname: Christian
authors.forename: Joel F
authors.initials: JF
authors.lastname: Farley
authors.forename: Brian
authors.initials: B
authors.lastname: Sheitman
authors.forename: Jerry R
authors.initials: JR
authors.lastname: McKee
authors.forename: David
authors.initials: D
authors.lastname: Wei
authors.forename: John
authors.initials: J
authors.lastname: Diamond
authors.forename: Alan
authors.initials: A
authors.lastname: Chrisman
authors.forename: Larry Jarrett
authors.initials: LJ
authors.lastname: Barnhill
authors.forename: Lynn
authors.initials: L
authors.lastname: Wegner
authors.forename: Guy
authors.initials: G
authors.lastname: Palmes
authors.forename: Troy
authors.initials: T
authors.lastname: Trygstad
authors.forename: Trista
authors.initials: T
authors.lastname: Pfeiffenberger
authors.forename: Steven E
authors.initials: SE
authors.lastname: Wegner
authors.forename: Randell
authors.initials: R
authors.lastname: Best
authors.forename: Linmarie
authors.initials: L
authors.lastname: Sikich
mesh_terms: D014150:Antipsychotic Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy* / Q000453:epidemiology; D009657:North Carolina / Q000453:epidemiology; D012042:Registries / Q000706:statistics & numerical data*
chemical_list: D014150:Antipsychotic Agents