Participating Faculty

This supplement to The American Journal of Managed Care provides information on the clinical characteristics, diagnosis, and treatment of ADHD in plan members of all ages, in addition to discussing managed care initiatives for improving therapeutic adherence and optimizing patient outcomes.

Participating Faculty

Julie A. Dopheide, PharmD, BCPP

Associate Professor of Clinical Pharmacy,

Psychiatry and the Behavioral Sciences

University of Southern California

Schools of Pharmacy and Medicine

Los Angeles, California

Peter S. Jensen, MD

President & CEO

The REACH Institute

REsource for Advancing Children's Health

New York, New York

Neil B. Minkoff, MD

Medical Director

Network Medical Management and Pharmacy

Harvard Pilgrim Health Care

Wellesley, Massachusetts

Faculty Disclosures

Disclosure of Conflicts of Interest

Postgraduate Institute for Medicine (PIM) assesses conflict of interest with its instructors, planners, managers, and other individuals who are in a position to control the content of CME activities. All relevant conflicts of interest that are identified are thoroughly vetted by PIM for fair balance, scientific objectivity of studies utilized in this activity, and patient care recommendations. PIM is committed to providing its learners with high-quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest or a commercial interest. The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

Julie A. Dopheide, PharmD, BCPP

Consultant:

Ortho-McNeil Janssen Scientific Affairs, LLC

Shire

Peter S. Jensen, MD

Consultant:

Ortho-McNeil Janssen Scientific Affairs, LLC

Otsuka America Pharmaceutical, Inc.

Shire

Neil B. Minkoff, MD, reports no financial interest/relationship relating to the topic of this activity.

The planners and managers reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity: Steve Casebeer, MBA (Impact Education, LLC), Trace Hutchison, PharmD (PIM), Jan Hixon, RN, BSN, MA (PIM), Linda Graham, RN, BSN, BA (PIM), Julia Kirkwood, RN, BSN (PIM), and Jan Schultz, RN, MSN (PIM) report no financial interest/relationships relating to the topic of this activity.

Method of Participation

There are no fees for participating and receiving CME credit for this activity. During the period May 15, 2009, through May 31, 2010, participants must (1) read the learning objectives and faculty disclosures; (2) study the educational activity; (3) complete the posttest by recording the best answer to each question in the answer key on the evaluation form; (4) complete the evaluation form; and (5) mail or fax the evaluation form with answer key to Postgraduate Institute for Medicine.

A statement of credit will be issued only upon receipt of a completed activity evaluation form and a completed posttest with a score of 70% or better. Your statement of credit will be mailed to you within 3 weeks.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the US Food and Drug Administration. Postgraduate Institute for Medicine (PIM), Impact Education, LLC, and Ortho-McNeil Janssen Scientific Affairs, LLC do not recommend the use of any agent outside of the labeled indications. The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of PIM, Impact Education, LLC, and Ortho-McNeil Janssen Scientific Affairs, LLC. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Disclaimer

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient's conditions and possible contraindications on dangers in use, review of any applicable manufacturer's product information, and comparison with recommendations of other authorities.

Getting to Goal: Managed Care Strategies for Children, Adolescents, and Adults With ADHD

Release date: May 15, 2009; Expiration date: November 30, 2010

TARGET AUDIENCE

This activity has been designed to meet the educational needs of physicians, managed care pharmacists, pharmacy directors, medical directors, quality directors, policy executives, and other key managed care administrators involved in the management of patients with attention-deficit/hyperactivity disorder (ADHD).

MEDIA

Journal supplement

EDUCATIONAL OBJECTIVES

After completing this activity, the participant should be better able to:

• Describe the overall costs associated with ADHD and related comorbidities.

• Specify the clinical and financial impact of various ADHD treatment options.

•

Describe a managed care road map for improving clinical and economic outcomes for ADHD.

•

Cite recommendations for health plans to assist their providers with strategies to improve HEDIS performance scores for ADHD.

•

Identify a step therapy model to provide appropriate drug therapy for ADHD treatment by managed care.

STATEMENT OF NEED/PROGRAM OVERVIEW

ADHD is considered the most common neurobehavioral disorder in children, affecting an estimated 4% to 12% of school-age children. Approximately one third to one half of all pediatric mental health referrals are due to ADHD. In addition to ADHD, many children have comorbid conditions, such as anxiety disorders, conduct disorder, and learning disorders. ADHD that begins in early childhood persists into adulthood in up to two thirds of cases. According to the National Comorbidity Survey Replication (NCS-R), the estimated prevalence rate of adult ADHD in the United States is 4.4%.

Adherence is a critical aspect of care because of the chronicity of lifelong ADHD consequences from significant symptoms that continue to exhibit in adulthood. Among children with ADHD, those on medication have shown to have significantly less frequent and less costly emergency department visits. In the absence of consistent treatment, adolescents with ADHD suffer 4 times as many serious injuries and 3 times as many motor vehicle accidents versus those without ADHD or those with ADHD who are medication compliant.

The increasing incidence of ADHD is an issue for managed care organizations and their providers. Providers are already feeling stretched to deliver adequate care for neurobehavioral disorders, so there is a need to increase their comfort in prescribing medicines along with behavioral recommendations for patients with ADHD. Education is needed to learn more about the use of controlled versus noncontrolled agents. The diversion of drugs within the ADHD category remains an issue with the managed care audience; therefore, recommendations are needed that help monitor inappropriate usage.

All of the above have fostered barriers to ADHD treatment and poor adherence to treatment guidelines, including the American Academy of Child and Adolescent Psychiatry, the American Academy of Pediatrics, the National Institutes of Health, and Healthcare Effectiveness Data and Information Set (HEDIS) recommendations. By following the treatment guidelines and reducing restrictions to proper care and medications, managed care can implement an appropriate use strategy to improve outcomes for ADHD.

Physician Continuing Medical Education

Accreditation Statement

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Postgraduate Institute for Medicine (PIM) and Impact Education, LLC. PIM is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation

Postgraduate Institute for Medicine designates this educational activity for a maximum of 1.5 AMA PRA Category 1 Credits^TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Pharmacist Continuing Education

Accreditation Statement

Postgraduate Institute for Medicine is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Credit Designation

Postgraduate Institute for Medicine designates this continuing education activity for 1.5 contact hours (0.15 CEUs) of the Accreditation Council for Pharmacy Education. (Universal Activity Number - 809-999-08-254-H01-P) Estimated time to complete activity: 1.5 hours

Jointly sponsored by Postgraduate Institute for Medicine and Impact Education, LLC

Ortho-McNeil Janssen Scientific Affairs, LLC.

This activity is supported by an educational grant from McNeil Pediatrics administered by

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