Deborah Winders Davis1, Yana Feygin2, Liza Creel3, P Gail Williams4, W David Lohr5, V Faye Jones6, Jennifer Le7, Natalie Pasquenza2, Soutik Ghosal8, Kahir Jawad2, Xiaofang Yan8, Gil Liu9, Samantha McKinley10. 1. University of Louisville School of Medicine; Department of Pediatrics, Child & Adolescent Research Design & Support Unit, Louisville, KY, USA. Electronic address: deborah.davis@louisville.edu. 2. University of Louisville School of Medicine; Department of Pediatrics, Child & Adolescent Research Design & Support Unit, Louisville, KY, USA. 3. University of Louisville School of Medicine; Department of Pediatrics, Child & Adolescent Research Design & Support Unit, Louisville, KY, USA; University of Louisville School of Public Health and Information Sciences, Health Management & Systems Science, Louisville, KY, USA. 4. University of Louisville School of Medicine, Department of Pediatrics, Weisskopf Child Evaluation Center, Louisville, KY, USA. 5. University of Louisville School of Medicine; Department of Pediatrics, Child & Adolescent Research Design & Support Unit, Louisville, KY, USA; University of Louisville School of Medicine, Department of Pediatrics, Division of Child & Adolescent Psychiatry & Psychology, Louisville, KY, USA. 6. University of Louisville School of Medicine, Department of Pediatrics, Division of General Pediatrics, Louisville, KY, USA. 7. University of Louisville School of Medicine, Department of Pediatrics, Division of Child & Adolescent Psychiatry & Psychology, Louisville, KY, USA. 8. University of Louisville School of Medicine; Department of Pediatrics, Child & Adolescent Research Design & Support Unit, Louisville, KY, USA; University of Louisville School of Public Health and Information Sciences, Bioinformatics and Biostatistics, Louisville, KY, USA. 9. University of Louisville School of Medicine, Department of Pediatrics, Division of General Pediatrics, Louisville, KY, USA; Kentucky Department of Medicaid Services, Frankfort, KY, USA. 10. Kentucky Department of Medicaid Services, Frankfort, KY, USA.
Abstract
OBJECTIVES: To describe trends in the diagnosis of attention-deficit/hyperactivity disorder (ADHD) and prescribing of stimulants in preschool-age children receiving Medicaid and to identify factors associated with the receipt of psychosocial care. STUDY DESIGN: Data were extracted from 2012-2016 Kentucky Medicaid claims for children aged <6 years. ADHD was identified using International Classification of Diseases, Tenth Revision codes F90.0, F90.1, F90.2, F90.8, and F90.9. Psychosocial therapy was defined as having at least 1 relevant Current Procedural Terminology code in a claim within the year. A generalized linear model with a logit link and binomial distribution was used to assess factors associated with receipt of psychosocial treatment in 2016. RESULTS: More than 2500 (1.24%) preschool-aged children receiving Medicaid had a diagnosis of ADHD in 2016, with 988 (38.2%) of those receiving a stimulant medication. Children in foster care were diagnosed with and/or treated for ADHD 4 times more often than other Medicaid recipients. Of the 1091 preschoolers receiving stimulants, 99 (9%) did not have a diagnosis of ADHD. There were no significant differences in diagnoses by race/ethnicity, but children reported to be black, Hispanic, or other race/ethnicity received stimulants at a lower rate than white children. Positive predictors for receiving psychosocial therapy in 2016 included having the diagnosis but not receiving a stimulant, having at least 1 prescription written by a psychiatrist, having comorbidities, and age. The use of stimulants in children aged <6 years declined from 0.9% in 2012 to 0.5% in 2016. CONCLUSIONS: Promising trends demonstrate a decreasing use of stimulants in preschoolers; however, continued vigilance is needed to promote the optimal use of psychosocial interventions.
OBJECTIVES: To describe trends in the diagnosis of attention-deficit/hyperactivity disorder (ADHD) and prescribing of stimulants in preschool-age children receiving Medicaid and to identify factors associated with the receipt of psychosocial care. STUDY DESIGN: Data were extracted from 2012-2016 Kentucky Medicaid claims for children aged <6 years. ADHD was identified using International Classification of Diseases, Tenth Revision codes F90.0, F90.1, F90.2, F90.8, and F90.9. Psychosocial therapy was defined as having at least 1 relevant Current Procedural Terminology code in a claim within the year. A generalized linear model with a logit link and binomial distribution was used to assess factors associated with receipt of psychosocial treatment in 2016. RESULTS: More than 2500 (1.24%) preschool-aged children receiving Medicaid had a diagnosis of ADHD in 2016, with 988 (38.2%) of those receiving a stimulant medication. Children in foster care were diagnosed with and/or treated for ADHD 4 times more often than other Medicaid recipients. Of the 1091 preschoolers receiving stimulants, 99 (9%) did not have a diagnosis of ADHD. There were no significant differences in diagnoses by race/ethnicity, but children reported to be black, Hispanic, or other race/ethnicity received stimulants at a lower rate than white children. Positive predictors for receiving psychosocial therapy in 2016 included having the diagnosis but not receiving a stimulant, having at least 1 prescription written by a psychiatrist, having comorbidities, and age. The use of stimulants in children aged <6 years declined from 0.9% in 2012 to 0.5% in 2016. CONCLUSIONS: Promising trends demonstrate a decreasing use of stimulants in preschoolers; however, continued vigilance is needed to promote the optimal use of psychosocial interventions.
Authors: Rebecca H Bitsko; Angelika H Claussen; Jesse Lichstein; Lindsey I Black; Sherry Everett Jones; Melissa L Danielson; Jennifer M Hoenig; Shane P Davis Jack; Debra J Brody; Shiromani Gyawali; Matthew J Maenner; Margaret Warner; Kristin M Holland; Ruth Perou; Alex E Crosby; Stephen J Blumberg; Shelli Avenevoli; Jennifer W Kaminski; Reem M Ghandour Journal: MMWR Suppl Date: 2022-02-25
Authors: Sneha M Vaddadi; Nicholas J Czelatka; Belsy D Gutierrez; Bhumika C Maddineni; Kenneth L McCall; Brian J Piper Journal: PeerJ Date: 2021-12-21 Impact factor: 2.984
Authors: Ann C Childress; Eric Lloyd; Steven A Johnson; Lhanoo Gunawardhana; Valerie Arnold Journal: J Child Adolesc Psychopharmacol Date: 2022-03-08 Impact factor: 2.576
Authors: Eric M Bomberg; Elise F Palzer; Kyle D Rudser; Aaron S Kelly; Carolyn T Bramante; Hilary K Seligman; Favour Noni; Claudia K Fox Journal: Ther Adv Endocrinol Metab Date: 2022-04-11 Impact factor: 4.435
Authors: Ann C Childress; Robert L Findling; James Wu; Scott H Kollins; Yi Wang; Patrick Martin; Brigitte Robertson Journal: J Child Adolesc Psychopharmacol Date: 2020-02-11 Impact factor: 2.576