Gail A Edelsohn1, Irina Karpov2, Meghna Parthasarathy2, Shari L Hutchison2, Kim Castelnovo2, Jaswinder Ghuman2, James M Schuster3. 1. Community Care Behavioral Health Organization, UPMC Insurance Division, Pittsburgh. Electronic address: edelsohnga@ccbh.com. 2. Community Care Behavioral Health Organization, UPMC Insurance Division, Pittsburgh. 3. Community Care Behavioral Health Organization, UPMC Insurance Division, Pittsburgh; Behavioral Health and Medicaid Services, Behavioral Health Integration, UPMC Insurance Division and University of Pittsburgh School of Medicine.
Abstract
OBJECTIVE: To examine trends in the use of antipsychotic medication in Medicaid-eligible youth from 2008 to 2013 and the factors associated with this use. METHOD: Youth aged 0 to 17 years with at least one claim indicating antipsychotic medication use were identified from the network of a behavioral health managed care organization (BHMCO). Demographic and clinical variables were derived from state eligibility data and service claims data from the BHMCO. Overall and specific prevalence rates of antipsychotic drug use were calculated over the course of 6 years (2008-2013). The probability of antipsychotic use during 2013 was further explored with logistic regression that included demographic and diagnostic groups. RESULTS: The overall trend in prevalence for antipsychotics for youth decreased from 49.52 per 1,000 members in 2008 to 30.54 in 2013 (p < .0001). Although rates decreased for all age groups, the rate per 1,000 members in 2013 for the youngest children was 3.79, versus 39.23 for 6- to 12-year-olds and 64.33 for 13- to 17-year-olds. Controlling for demographic and clinical variables, children 0 to 5 years old were 79% less likely to be prescribed antipsychotic medications compared to the oldest youth, 13 to 17 years of age (p < .0001). Rates were higher for males versus females regardless of age (odds ratio [95% CI] =1.48 [1.36-1.62], p < .0001). Children with a diagnosis of attention-deficit/hyperactivity disorder were less likely to be prescribed antipsychotics compared to those with diagnoses of autism spectrum disorder, bipolar disorder, psychoses, and depression. CONCLUSION: Prevalence rates decreased significantly over time for all socio-demographic groups. The largest decrease was observed for the youngest children, ages 0 to 5 years, with a rate in 2013 under half the rate for 2008. Clinical, policy, and managed care implications are discussed.
OBJECTIVE: To examine trends in the use of antipsychotic medication in Medicaid-eligible youth from 2008 to 2013 and the factors associated with this use. METHOD: Youth aged 0 to 17 years with at least one claim indicating antipsychotic medication use were identified from the network of a behavioral health managed care organization (BHMCO). Demographic and clinical variables were derived from state eligibility data and service claims data from the BHMCO. Overall and specific prevalence rates of antipsychotic drug use were calculated over the course of 6 years (2008-2013). The probability of antipsychotic use during 2013 was further explored with logistic regression that included demographic and diagnostic groups. RESULTS: The overall trend in prevalence for antipsychotics for youth decreased from 49.52 per 1,000 members in 2008 to 30.54 in 2013 (p < .0001). Although rates decreased for all age groups, the rate per 1,000 members in 2013 for the youngest children was 3.79, versus 39.23 for 6- to 12-year-olds and 64.33 for 13- to 17-year-olds. Controlling for demographic and clinical variables, children 0 to 5 years old were 79% less likely to be prescribed antipsychotic medications compared to the oldest youth, 13 to 17 years of age (p < .0001). Rates were higher for males versus females regardless of age (odds ratio [95% CI] =1.48 [1.36-1.62], p < .0001). Children with a diagnosis of attention-deficit/hyperactivity disorder were less likely to be prescribed antipsychotics compared to those with diagnoses of autism spectrum disorder, bipolar disorder, psychoses, and depression. CONCLUSION: Prevalence rates decreased significantly over time for all socio-demographic groups. The largest decrease was observed for the youngest children, ages 0 to 5 years, with a rate in 2013 under half the rate for 2008. Clinical, policy, and managed care implications are discussed.
Authors: Christina D Kang-Yi; Brian Chao; Shelly Teng; Jill Locke; David S Mandell; Yin-Ling Irene Wong; C Neill Epperson Journal: Front Psychiatry Date: 2020-06-04 Impact factor: 4.157
Authors: Vincent Besch; Christian Greiner; Charline Magnin; Mélanie De Néris; Julia Ambrosetti; Nader Perroud; Emmanuel Poulet; Martin Debbané; Paco Prada Journal: Int J Environ Res Public Health Date: 2020-11-24 Impact factor: 3.390
Authors: Joseph C Blader; Steven R Pliszka; Vivian Kafantaris; Carmel A Foley; Gabrielle A Carlson; Judith A Crowell; Brigitte Y Bailey; Colin Sauder; W Burleson Daviss; Christa Sinha; Thomas L Matthews; David M Margulies Journal: J Am Acad Child Adolesc Psychiatry Date: 2020-01-30 Impact factor: 8.829
Authors: Robert B Penfold; Ella E Thompson; Robert J Hilt; Nadine Schwartz; Adelaide S Robb; Christoph U Correll; Douglas Newton; Kelly Rogalski; Marian F Earls; Robert A Kowatch; Arne Beck; Bobbi Jo H Yarborough; Stephen Crystal; Benedetto Vitiello; Kelly J Kelleher; Gregory E Simon Journal: J Am Acad Child Adolesc Psychiatry Date: 2021-05-04 Impact factor: 8.829
Authors: Deborah Winders Davis; W David Lohr; Yana Feygin; Liza Creel; Kahir Jawad; V Faye Jones; P Gail Williams; Jennifer Le; Marie Trace; Natalie Pasquenza Journal: BMC Psychiatry Date: 2021-06-10 Impact factor: 3.630
Authors: Laura J Chavez; Kelly J Kelleher; Arne Beck; Gregory N Clarke; Robert B Penfold Journal: J Child Adolesc Psychopharmacol Date: 2021-06 Impact factor: 3.031