naire was self-administered via paper and pencil before depositing in a survey drop box . Completion of the questionnaire was indicative of informed consent to participate . Due to the voluntary and anonymous nature of the recruitment process , there was no attempt to gather information from individuals who did not participate in the study , survey distribution was not tracked , and no information is available on survey response rates .
The Prescription Experiences survey consisted of 15 total items : six demographic and baseline medication questions , eight questions relating to experiences with PA ( i . e ., frequency and length of delays in getting medication , type of adverse effects as a result of delays in getting medication , questions about the need to change medications as a result of inability to obtain PA , and one separate follow-up contact question ). The questions asked families to report the name and number of medications that were impacted by previous problems with PA at any time . Participants were then asked to provide details of the delays ( i . e ., which medications , how often they experienced delays , length of the most recent delay ). Caregivers were able to endorse multiple medications that required PA or were delayed . Participants were asked to report whether their child and family ever experienced adverse effects as a result of medication delays due to PA requirements . Adverse events included the opportunity to select categories ( e . g ., behavioral , emotional , school , financial ) and open-ended questions . Caregivers were able to endorse multiple adverse events . Completed surveys were collated in Red- Cap and analyzed for basic descriptive statistics in SPSS data analysis software .
Medication Class
FIGURE 1 : Medications Reported as Requiring Prior Authorization
Stimulant 22 Alpha Agonist 9 Atypical Antipsychotic 7 Selective Serotonin Reuptake Inhibitor ( SSRI ) 7 Other Antipsychotic 4 Atomoxetine 2 Beta Blocker 2 Antiepileptic Drug ( AED ) 1 Other 1 Total 55
Number of Respondents
10 9 8 7 6 5 4 3 2 1 0
Number of Prescriptions Reported as Being Impacted by Prior Authorization Requirements
FIGURE 2 : Length of Delay ( Days ) Reported by Parents Before Obtaining Medication Due to Prior Authorization Requirements
3
7
9
< 1 1-2 3-7 8-14 14 + Length of Delay ( Days )
3
6
RESULTS
Twenty-three biological parents , six adoptive parents , four grandparents , and four other family members responded to the survey on behalf of the patient , for a total of 37 parents / caregivers . The mean age of respondents ’ child was 12 years ( range 5-17 years ). No other descriptive information was collected , therefore other sample characteristics are not available . While the individual characteristics of responders was not collected , the overall payor mix of the clinic is approximately 50 % private and 50 % public payors . The vast majority of prior authorizations required for the clinic population ( 90 %) are from Medicaid payors .
Just over 75 % ( n = 28 ) of respondents reported that they had ever had a problem filling their child ’ s medication prescription due to the PA process . The participants reported a total of 55 medications requiring PA at any point ( Figure 1 ). All
28 of participants who reported a problem with PA also reported a delay in obtaining prescribed medication ( n = 28 , 100 %). The mean number of occasions where medication was delayed due to PA was reported to be 4.5 ( n = 20 , SD 4.65 ). Eight additional subjects responded subjectively indicating multiple occasions without a specific numerical response ( e . g . too many to remember ). Figure 2 shows the length of time that patients reported their medication was
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