Product information and disease description Product description Product information

Effect of LB-102 on quality measures

18 evidence topics · 17 sources

HEDIS Adherence to Antipsychotic Medications for Individuals With Schizophrenia (SAA): definition and rationale

“The percentage of persons 18 years of age and older during the measurement period, with schizophrenia or schizoaffective disorder, who were dispensed and remained on an antipsychotic medication for at least 80% of their treatment period.” (opens the source at this quote in a new tab)
“Non-adherence increases risk of re-hospitalization, emergency psychiatric treatment, functional decline and death.” (opens the source at this quote in a new tab)
“Measuring antipsychotic medication adherence may encourage efforts aimed at reducing medication nonadherence and, in turn, lead to lower relapse rates and fewer hospitalizations.” (opens the source at this quote in a new tab)

HEDIS Diabetes Screening for People With Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications (SSD): definition and rationale

“The percentage of persons 18–64 years of age with schizophrenia, schizoaffective disorder or bipolar disorder who were dispensed an antipsychotic medication and had a diabetes screening test during the measurement period.” (opens the source at this quote in a new tab)
“Diabetes screening is important for anyone with schizophrenia, schizoaffective disorder or bipolar disorder, and the added risk associated with antipsychotic medications contributes to the need to screen for diabetes.” (opens the source at this quote in a new tab)

HEDIS Diabetes Monitoring for People With Diabetes and Schizophrenia (SMD): definition and rationale

“The percentage of persons 18–64 years of age with schizophrenia or schizoaffective disorder and diabetes who had both an LDL-C test and an HbA1c test during the measurement period.” (opens the source at this quote in a new tab)
“In addition to general diabetes risk factors, diabetes is promoted in patients with schizophrenia by initial and current treatment with olanzapine and mid-potency first-generation antipsychotics (FGA), as well as by current treatment with low-potency FGAs and clozapine (1).” (opens the source at this quote in a new tab)

HEDIS Cardiovascular Monitoring for People With Cardiovascular Disease and Schizophrenia (SMC): definition and rationale

“The percentage of persons 18–64 years of age with schizophrenia or schizoaffective disorder and cardiovascular disease, who had an LDL-C test during the measurement period.” (opens the source at this quote in a new tab)
“Among patients with co-occurring schizophrenia and metabolic disorders, rates of nontreatment were 62.4% for hypertension and 88.0% for hyperlipidemia.” (opens the source at this quote in a new tab)
“Atypical antipsychotic medications elevate the risk of metabolic conditions, relative to typical antipsychotic medications (4).” (opens the source at this quote in a new tab)

HEDIS Follow-Up After Hospitalization for Mental Illness (FUH): definition and rationale

“The percentage of discharges for persons 6 years of age and older who were hospitalized for a principal diagnosis of mental illness, or any diagnosis of intentional self-harm, and had a mental health follow-up service.” (opens the source at this quote in a new tab)
“The percentage of discharges for which the person received follow-up within 30 days after discharge.” (opens the source at this quote in a new tab)
“The percentage of discharges for which the person received follow-up within 7 days after discharge.” (opens the source at this quote in a new tab)
“Early interventions and proactive management of potential challenges can reduce risk of readmission and promote sustained well-being.” (opens the source at this quote in a new tab)

HEDIS Follow-Up After Emergency Department Visit for Mental Illness (FUM): definition and rationale

“The percentage of emergency department (ED) visits for persons 6 years of age and older with a principal diagnosis of mental illness, or any diagnosis of intentional self-harm, and had a mental health follow-up service.” (opens the source at this quote in a new tab)
“The percentage of ED visits for which the person received follow-up within 30 days of the ED visit (31 total days).” (opens the source at this quote in a new tab)
“The percentage of ED visits for which the person received follow-up within 7 days of the ED visit (8 total days).” (opens the source at this quote in a new tab)
“Evidence suggests that patients who fail to receive aftercare following their emergency psychiatric visit have 6 times higher odds of returning to the ED within 2 months, compared with patients who received aftercare (5).” (opens the source at this quote in a new tab)

HEDIS Metabolic Monitoring for Children and Adolescents on Antipsychotics (APM): pediatric measure, for context

“Assesses the percentage of children and adolescents with ongoing antipsychotic medication use who had metabolic testing during the year.” (opens the source at this quote in a new tab)
“Given these risks and the potential lifelong consequences, metabolic monitoring (blood glucose and cholesterol testing) is an important component of ensuring appropriate management of children and adolescents on antipsychotic medications.” (opens the source at this quote in a new tab)

NCQA 2027 Health Plan Ratings: SAA, FUH, and FUM scored for commercial, Medicare, and Medicaid plans, and SSD for Medicaid plans

“2027 Health Plan Ratings Required HEDIS® and CAHPS® Measures” (opens the source at this quote in a new tab)
“Commercial & Medicaid HEDIS MY 2026 & CAHPS MY 2026 (Reporting Year 2027)” (opens the source at this quote in a new tab)

Measure	Display name	Weight
SAA	“Adherence to antipsychotic medications for individuals with schizophrenia”	“1”
SSD	“Diabetes screening for individuals with schizophrenia or bipolar disorder”	“1”
FUH	“Follow-up after hospitalization for mental illness”	“1”
FUM	“Follow-up after ED for mental illness”	“1”

CMS 2027 Medicaid Adult Core Set: mandatory behavioral health measures that apply to schizophrenia

“2027 Mandatory Adult Core Set Measures” (opens the source at this quote in a new tab)
“Follow-Up After Hospitalization for Mental Illness: Age 18 and Older (FUH-AD)” (opens the source at this quote in a new tab)
“Diabetes Screening for People With Schizophrenia or Bipolar Disorder Who Are Using Antipsychotic Medications (SSD-AD)” (opens the source at this quote in a new tab)
“Diabetes Care for People with Serious Mental Illness: Glycemic Status > 9.0% (HPCMI-AD)” (opens the source at this quote in a new tab)
“Follow-Up After Emergency Department Visit for Mental Illness: Age 18 and Older (FUM-AD)” (opens the source at this quote in a new tab)
“Adherence to Antipsychotic Medications for Individuals With Schizophrenia (SAA-AD)” (opens the source at this quote in a new tab)
“The Adult Core Set includes the NCQA version of the measure, which is adapted from the CMS measure.” (opens the source at this quote in a new tab)

National performance: state Medicaid medians on SAA-AD and SSD-AD, 2023 Adult Core Set

“Adherence to these antipsychotics for the treatment of schizophrenia can reduce the risk of relapse or hospitalization.” (opens the source at this quote in a new tab)
“A median of 62 percent of adults age 18 and older during calendar year 2022 with schizophrenia or schizoaffective disorder remained on an antipsychotic medication for at least 80 percent of their treatment period.” (opens the source at this quote in a new tab)
“A median of 77 percent of adults ages 18 to 64 with schizophrenia, schizoaffective disorder, or bipolar disorder who were dispensed an antipsychotic had a diabetes screening test during calendar year 2022.” (opens the source at this quote in a new tab)

National performance: state Medicaid medians on FUH-AD and FUM-AD, 2023 Adult Core Set

“A median of 32 percent of discharges for adults ages 18 to 64 who were hospitalized for treatment of selected mental illness or intentional self-harm diagnoses from January 1 to December 1, 2022 had a follow-up visit within 7 days after discharge.” (opens the source at this quote in a new tab)
“A median of 54 percent of discharges for adults ages 18 to 64 who were hospitalized for treatment of selected mental illness or intentional self-harm diagnoses from January 1 to December 1, 2022 had a follow-up visit within 30 days after discharge.” (opens the source at this quote in a new tab)
“A median of 35 percent of ED visits for adults ages 18 to 64 with mental illness or intentional self-harm diagnoses from January 1 to December 1, 2022 had a follow-up visit within 7 days.” (opens the source at this quote in a new tab)
“A median of 51 percent of ED visits for adults ages 18 to 64 with mental illness or intentional self-harm diagnoses from January 1 to December 1, 2022 had a follow-up visit within 30 days.” (opens the source at this quote in a new tab)

Quality metrics among Medicaid beneficiaries with schizophrenia: national claims, 2018

“Across the US 688,437 patients with schizophrenia were identified.” (opens the source at this quote in a new tab)
“The proportion of patients adherent to any AP was 56% (range: 19-73%).” (opens the source at this quote in a new tab)
“Within 30 days post-discharge from an inpatient admission, 22% (range: 8-58%) of patients had an outpatient visit, and 12% (range: 4-48%) had a readmission.” (opens the source at this quote in a new tab)

Quality metrics among fee-for-service Medicare beneficiaries with schizophrenia: national claims, 2019

“We identified 314,888 beneficiaries with schizophrenia.” (opens the source at this quote in a new tab)
“Among those with hospitalizations, 18.4% and 27.3% had readmission within 7 and 30 days and 56% and 67% had a physician visit and AP fill within 30 days post-discharge, respectively.” (opens the source at this quote in a new tab)
“Overall, 81% of beneficiaries were deemed adherent to their AP medications.” (opens the source at this quote in a new tab)

Attainment of the HEDIS antipsychotic continuity measure in Medicaid claims and associated factors

“Among the 12,990 patients who received an antipsychotic during the study period, 48.6% successfully achieved the continuity criteria in the measurement year.” (opens the source at this quote in a new tab)
“After controlling for other covariates, the odds of adherence were improved by adherence at baseline (odds ratio [OR], 9.42; 95% confidence interval [CI], 8.55–10.39).” (opens the source at this quote in a new tab)

Adherence and outcomes: gaps in antipsychotic coverage and rehospitalization in California Medicaid

“Compliance behavior was estimated by using a retrospective review of California Medicaid pharmacy refill and medical claims for 4,325 outpatients for whom antipsychotics were prescribed for treatment of schizophrenia from 1999 to 2001.” (opens the source at this quote in a new tab)
“For example, the presence of any gap in medication coverage was associated with increased risk of hospitalization, including gaps as small as one to ten days (odds ratio [OR]=1.98).” (opens the source at this quote in a new tab)
“A gap of 11 to 30 days was associated with an OR of 2.81, and a gap of more than 30 days was associated with an OR of 3.96.” (opens the source at this quote in a new tab)

Adherence and outcomes: Medicaid inpatient admissions and costs attributable to gaps in antipsychotic treatment

“In the United States, there are roughly 87 000 annual acute care inpatient admissions of Medicaid patients for the treatment of schizophrenia.” (opens the source at this quote in a new tab)
“These admissions include a total of approximately 930 000 hospital days at a total cost of $806 million.” (opens the source at this quote in a new tab)
“Improving adherence to eliminate gaps in antipsychotic medication treatment could lower the number of acute care admissions by approximately 12.3% (95% confidence interval [CI]: 11.7%–12.6%) and reduce the number of inpatient treatment days by approximately 13.1% (CI: 9.8%–16.5%) resulting in a savings of approximately $106 million (95% CI: $79.0 million–$133.0 million) in inpatient care costs for the national Medicaid system.” (opens the source at this quote in a new tab)

Follow-up after hospitalization and outcomes: outpatient visit within 30 days and readmission risk

“Among inpatients with schizophrenia (N=25,401) or bipolar disorder (N=46,375), overall and stratified associations were examined between receipt of an outpatient follow-up visit in the 30 days postdischarge and hospital readmission during days 31-120 postdischarge.” (opens the source at this quote in a new tab)
“Receipt of a follow-up visit within 30 days of discharge was associated with a slightly lower adjusted odds ratio (AOR) of hospital readmission during days 31-120 postdischarge (schizophrenia, AOR=.88, 95% confidence interval [CI]=.81-.96; bipolar disorder, AOR=.91, CI=.85-.98).” (opens the source at this quote in a new tab)
“For patients with schizophrenia, the strongest observed inverse association of follow-up care with readmission risk was among inpatients whose index admissions were 13 to 30 days long (AOR=.73, CI=.61-.89).” (opens the source at this quote in a new tab)

Follow-up after hospitalization: rates and antipsychotic-related predictors in national Medicaid claims

“Of the 59,567 hospital discharges, 41.7% received schizophrenia-related outpatient visits in 7 days and 59.3% in 30 days following hospital discharge.” (opens the source at this quote in a new tab)
“The adjusted odds of 30-day follow-up outpatient visits were significantly related to preadmission outpatient mental health visits (AOR = 3.72; 99% CI, 3.44-4.03), depot (AOR = 2.83; 99% CI, 2.53-3.18) or oral (AOR = 1.73; 99% CI, 1.62-1.84) antipsychotics as compared with no antipsychotics, and absence of a substance use disorder diagnosis (AOR = 1.35; 99% CI, 1.25-1.45).” (opens the source at this quote in a new tab)

LB-102-specific effect on quality measures

No evidence found.