314472
Treatment sequencing prior to antipsychotic initiation among youth in foster care
Methods: A retrospective cohort study, new user cohort design was conducted to assess antipsychotic initiation among youth who were involved in foster care during the period January 2010 through May 2013. Data from child welfare was merged with Medicaid mental health claims data in one large, Mid-Atlantic city. Treatment patterns prior to antipsychotic initiation were compared with American Academy of Child and Adolescent Psychiatry practice parameters.
Results: There were 8,545 youth aged 21 years or younger in foster care any time during January 2010 through May 2013. Of these, 1,015 (12%) received an antipsychotic medication any time during the study period, 222 (22%) had no evidence of antipsychotic treatment in the 180 days prior, i.e., new initiators. Among new initiators of antipsychotics, 95% had not received any other psychotropic medication in the prior 180 days. Similarly, few (5%) had any visits for psychotherapy treatment prior to initiating antipsychotic treatment.
Conclusions: Treatment patterns prior to initiating antipsychotic treatment were not consistent with evidence-base practice parameters for psychotropic use among children. Low use of psychotherapy may be due to lack of available resources. Psychotropic monitoring programs are needed to improve the uptake of evidence-based treatment for youth in foster care.
Learning Areas:
Clinical medicine applied in public healthEpidemiology
Other professions or practice related to public health
Public health or related laws, regulations, standards, or guidelines
Public health or related organizational policy, standards, or other guidelines
Social and behavioral sciences
Learning Objectives:
Identify mental health conditions and symptoms of children for which medications are prescribed
Describe treatment sequencing prior to antipsychotic initiation
Name foster placement outcomes following initiation
Keyword(s): Child/Adolescent Mental Health, Social Services
Qualified on the content I am responsible for because: I am qualified to be a presenter in this symposium given my own research on the safety of antipsychotic use among children and my medical training allows me to speak on the clinical perspective of the observed practice trends.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.
Qualified on the content I am responsible for because: My research expertise has focused on pharmacoepidemiologic research that has been supported by several federally-funded research grants through the National Institute of Mental Health (NIMH) and the Patient Centered Outcomes Research Institute (PCORI). I have a solid foundation of research on psychotropic medication use among children and adolescents. My primary authored and co-authored publications have addressed psychotropic medication treatment patterns among youth in community settings, including foster care.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.