New machine learning approach transforms behavioural health medication practices
At the recent AMCP Nexus 2023 conference in Orlando, Florida (16th-19th of October), presenters showcased a groundbreaking machine learning program designed to address medication-related issues in individuals with behavioural health conditions. This program has shown promising results in reducing polypharmacy, enhancing medication adherence, and decreasing healthcare costs.
Behavioural health conditions pose a significant challenge to healthcare systems. A 2020 Milliman study examining commercial healthcare claims data from 2017, which encompassed 21 million people, revealed that although only 27% had a behavioural health condition, they accounted for over half of the total healthcare expenditures. In this context, machine learning offers a potential solution for better managing these conditions.
The presenters highlighted the issue of polypharmacy, a common concern in behavioural health where 60% of adults with a condition are prescribed two or more psychotropic medications. Polypharmacy not only increases the risk of drug interactions and adverse events but also contributes to soaring healthcare costs. Dr. Caroline Carney, Chief Medical Officer at Magellan Health, underscored the tendency for medication overlap and overprescription in treating conditions like depression and anxiety, often leading to unnecessary medication layers.
Another issue in managing behavioural health medications is the multiple prescribers involved, including primary care doctors, specialists, and inpatient clinicians, often resulting in uncoordinated treatment. This lack of coordination can leave patients confused and overwhelmed with their medication regimens.
To combat these challenges, Magellan Health collaborated with Arine, a medication management tech startup, to create inforMED (formerly known as Navigate Whole Health). This AI-driven program identifies prescribers who can potentially optimise patient care, generating comprehensive care plans with treatment recommendations and patient education. The program’s effectiveness is continuously improved by incorporating new clinical outcome data.
Dr. Carney elaborated on the program’s approach, which considers hundreds of parameters, providing prescribers not just with medication change suggestions but also with reasons, implications, and evidence-based support for the recommended changes.
Yoona Kim, PharmD, PhD, co-founder and CEO of Arine, explained that machine learning algorithms are utilised to target prescribers based on their prescribing patterns and the presence of prescribing outliers in their patient panels. The program also considers social determinants of health, using ZIP code data to assess potential barriers to healthcare access, such as low income or lack of vehicle access.
The results of this program have been significant. Dr. Kim reported a reduction in behavioural health polypharmacy by 45% to 55%, a 20% increase in medication adherence, a 20% reduction in average daily morphine milligram equivalents, and a savings of $360 to $840 in pharmaceutical costs per enrolled member annually.
Dr. Carney emphasised the program’s success in providing actionable data and guidance to healthcare providers, leading to improved patient outcomes and stronger, longer-lasting professional relationships. This innovative approach signifies a major step forward in the management of medication for behavioural health conditions.
