Magellan Health Services Offers E-Courses for Providers, Consumers And Families

E-Courses Focus on Critical Role of Peer Specialists

 AVON, Conn. – May 20, 2010 - Magellan Health Services, Inc., an industry leader in specialty health care management, has joined with the Depression and Bipolar Support Alliance (DBSA) to offer a new series of online learning opportunities to consumers, families and providers that address the pivotal and growing role of peer specialists in helping individuals work through and recover from mental illnesses. DBSA, which is considered the leading patient-directed national organization focused on prevalent mental illnesses such as depression, bipolar disorder and anxiety, designed the four new e-courses.

As individuals recovering from mental illnesses themselves, peer specialists are trained and certified to help others with mental health challenges gain hope and move forward in their own recovery. Magellan employs a number of peer specialists, directly and through its provider network, and regularly offers educational opportunities about their role through community presentations and provider-specific trainings.

“The Magellan/DBSA e-courses are unique in that they highlight the advantages of working with peer specialists for providers, consumers and families, in addition to those who supervise peer specialists,” said Anne McCabe, senior vice president of Magellan’s public sector behavioral health business unit. “To our knowledge, these are the only online courses that serve to educate a broad group about peers’ role in mental health recovery.”

Facts

The e-courses are offered free of charge at www.MagellanHealth.com/training.

• There are four e-courses that aim to help participants better understand the peer specialist’s role in helping others recover from mental illnesses:
  • #1: Research, Core Competencies and Ethics
  • #2: The Five Stages of Recovery and the Role of Peer Specialists
  • #3: Using your Recovery Story
  • #4: Effective Supervision of Peer Specialists
• The e-courses offer greater convenience than traditional on-site training programs, and each takes 30-45 minutes to complete.
• Each of the four new e-courses is tailored toward the beginner or intermediate skill level and offers providers in the Magellan network the opportunity to earn 1.0 Continuing Education (CE) credit hour. All other health care professionals who complete the new trainings will be issued a certificate of participation. Magellan is approved as a continuing education provider/sponsor by the American Psychological Association (APA), Association of Social Work Boards (ASWB), National Board of Certified Counselors (NBCC) and the National Association of Alcohol and Drug Abuse Counselors (NAADAC).
• These e-courses join 10 other interactive, self-guided training e-courses in the Magellan Resiliency and Recovery e-Learning Center, developed by Magellan in 2008.  Since their launch, more than 8,400 e-courses have been completed by individuals spanning all 50 states. When asked about their value, behavioral health providers in particular reported that the e-courses were helpful in refreshing their skills, providing ideas to implement in their area of practice and generally in helping them to do a better job serving consumers.

“Peer specialists are an integral part of the recovery process, as they’re able to empathize with consumers and understand their experiences in a very personal way,” said Lisa Goodale, vice president of training at DBSA, who is also a featured trainer in the new e-courses. “With the extensive behavioral health expertise of Magellan and DBSA as their foundation, we expect the e-courses will be a powerful benefit not only to consumers, families, providers and peer specialists’ supervisors, but to the behavioral health field, overall.”

New Study Finds Off-Label Use of Atypical Antipsychotics Increases Risk of Diabetes Among the Elderly

Diabetes Risk Well Documented in Young Schizophrenic and Bipolar Patients, But Was Not Considered a Risk Previously for Elderly

IRVINE, Calif.--(BUSINESS WIRE)-- A new study yields important new evidence that the use of atypical antipsychotics among the elderly for off-label purposes is associated with increased risk of developing diabetes.

Atypical antipsychotics (AAs) are a group of newer-generation antipsychotic drugs that are indicated for the treatment of psychiatric conditions including schizophrenia, bipolar mania and acute mania; but are often prescribed for unapproved indications (“off-label”) by physicians.

The study, conducted by Prescription Solutions, a leading pharmacy benefits management organization and a UnitedHealth Group (NYSE: UNH) company, was presented today at the 2010 Annual Scientific Meeting of the American Geriatrics Society (AGS) in Orlando, Fla. It was selected for presentation as part of the Presidential Poster Session open only to abstracts that received the highest scores through the AGS’ peer review process.

The correlation between the use of AAs and new-onset metabolic syndrome (which often leads to diabetes) has been widely documented in younger and middle-aged schizophrenic and bipolar patients. Previous studies suggested that because the elderly are usually given AAs in smaller doses than younger patients, the same weight gain and resulting diabetes would not be expected.

However, in this retrospective study of 78,450 elderly patients without diagnoses of schizophrenia, bipolar disorder or diabetes, an association was demonstrated between study patients being on an atypical antipsychotic and starting a diabetic medication. This was demonstrated even though 97 percent of the study patients with AA fills had doses within recommended guidelines for the treatment of dementia.¹ Elderly patients with at least one fill of an AA drug had 32-percent greater odds of starting a medication for diabetes within one year compared to similar patients without AA exposure.

“We are fortunate to have a wealth of retrospective data that helps us study the effects of medications on this growing population,” said Joseph Addiego, M.D., senior vice president and chief medical officer, Prescription Solutions. “The message for physicians who may be prescribing atypical antipsychotics for the elderly is to be careful not to discount the risk of new-onset diabetes, even when prescribing these drugs in small doses.”

Currently, AAs are widely used for off-label indications in the elderly for conditions such as dementia. Earlier studies may not have shown the same correlation between AAs and diabetes due to smaller study sample sizes or missing data. For example, the CATIE-AD trial² demonstrated that female patients with Alzheimer’s disease had significant weight gain with AA treatment, but the study was not powered to measure outcomes related to diabetes.

Study Methodology

• The study was designed as a case-control study using medical and pharmacy claims of Medicare (MAPD) and commercial managed care plan members in the western United States during an identification period of Jan. 1, 2004, through Dec. 31, 2008.
• The study group included 78,450 patients older than 65 years of age, without a diagnosis of schizophrenia or bipolar disorder, who were continuously enrolled and eligible for medical and pharmacy benefit during a one-year pre-index period. (The date range of the pre-index period depended on the index date identified, so they were different for the different patients.)
• The study identified 13,075 patients who first filled a diabetes medication during an index date within the identification period. More than 65,000 control subjects were matched at a ratio of 5:1 to case subjects based on age, gender, health plan type and index date year.
• The primary statistical analysis was a conditional logistic regression to determine the odds of starting antidiabetic medication for patients with AA exposure compared to those with no AA exposure, after adjusting for differences in clinical characteristics.

Study Limitations

• Patients may acquire a diagnosis of obesity independent of the use of an AA; therefore the use of this diagnosis as a proxy for weight gain associated with AA use may not be valid.
• The researchers were unable to account for differences in effects among the various atypical antipsychotics due to the small numbers of patients for each individual medication.
• Limitations of this database study include the lack of validation of diagnoses identified from medical claims, laboratory HbA1C data to verify diabetes, and information on ethnicity which may be a confounding factor in new-onset treatment-dependent diabetes.

The National Institute of Corrections and the Urban Institute announce the release of the Transition from Jail to Community (TJC) Implementation Toolkit. This web-based learning resource is designed to guide jurisdictions through implementation of the TJC model, in whole or in part. The Toolkit serves as a hands-on resource for users interested in jail reentry, whether in a criminal justice or community-based organization. Users can navigate the nine modules at their own pace. Toolkit modules incorporate examples from jurisdictions across the country, tools developed to facilitate implementation in the six current TJC learning sites, resource suggestions, and detailed content. The Toolkit can be accessed at http://www.jailtransition.com/Toolkit. 

Bazelon Center for Mental Health Law Statement on the Nomination of Elena Kagan

May 10, 2010 -- The Judge David L. Bazelon Center for Mental Health Law congratulates President Obama on his nomination of Solicitor General Elena Kagan to replace Justice John Paul Stevens on the Supreme Court. 

"The advancement of legal protections for people with disabilities has always been a bipartisan effort.  We need strong leaders on the courts to ensure that disability rights laws have the broad remedial effect Congress intended," said Robert Bernstein, Ph.D., executive director of the Bazelon Center.  "We hope General Kagan will be such a leader on the Supreme Court."

In the near future, the Supreme Court will likely take up issues of critical importance to people with disabilities, including the constitutionality and enforcement of this year's landmark health care reform legislation, which expands access to mental health treatment. The Court may also consider the first cases involving the 2008 Americans with Disabilities Act Amendments Act (ADAAA), which reaffirms the ADA's protections for thousands of people with disabilities, including individuals with mental illnesses.

"We appreciate Elena Kagan's demonstrated ability to bring together people from all sides of the political spectrum to reach consensus on the challenges we face and we look forward to learning more about her views on disability rights issues during the confirmation process," added Bernstein.