Factors Associated with Developmental Behavioral Pediatricians Prescribing Psychotropic Medication to Children with Autism Spectrum Disorder: A Study of Three DBPNet Sites.

Objective: Psychotropic medications are frequently prescribed to children with autism spectrum disorder (ASD), but little is known about the prescribing practices of developmental-behavioral pediatricians (DBPs). Our objective was to determine whether clinical site, age, insurance, or comorbidities...

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Publicado en:Journal of Developmental & Behavioral Pediatrics Vol. 38; no. 8; pp. 584 - 593
Autores principales: Jackel, Carissa, Shults, Justine, Wiley, Susan, Meinzen-Derr, Jareen, Augustyn, Marilyn, Blum, Nathan
Formato: research Journal Article
Publicado: Lippincott Williams & Wilkins Oct2017
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2017
      vid: 38
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      pub: Lippincott Williams & Wilkins
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        10.1097/DBP.0000000000000488
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        atl: Factors Associated with Developmental Behavioral Pediatricians Prescribing Psychotropic Medication to Children with Autism Spectrum Disorder: A Study of Three DBPNet Sites.
      aug:
        au:
          Jackel, Carissa
          Shults, Justine
          Wiley, Susan
          Meinzen-Derr, Jareen
          Augustyn, Marilyn
          Blum, Nathan
        affil: Division of Developmental and Behavioral Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA
      sug:
        subj:
          Medicaid Statistics and Numerical Data
          Psychotropic Drugs Therapeutic Use
          Child, Preschool
          Adolescence
          Female
          Retrospective Design
          United States
          Male
          Child
          Human
          Child, Preschool: 2-5 years
          Adolescent: 13-18 years
          Child: 6-12 years
          Female
          Male
      ab: Objective: Psychotropic medications are frequently prescribed to children with autism spectrum disorder (ASD), but little is known about the prescribing practices of developmental-behavioral pediatricians (DBPs). Our objective was to determine whether clinical site, age, insurance, or comorbidities influenced DBPs prescribing psychotropic medication for children with ASD.Methods: A retrospective analysis was performed using electronic health record data of all patients with ASD seen at 3 academic developmental-behavioral pediatrics (DBP) clinical programs from January 2010 to December 2011. Data included age, diagnoses, primary insurance, and medications prescribed. Factors associated with prescribing psychotropic medication were examined using generalized estimating equations.Results: Sites varied in the frequency with which they prescribed psychotropic medication for children with ASD (site 1: 33.1%, site 2: 49.3%, site 3: 4.0%; p < .001). We found that the following factors predicted prescribing of psychotropic medications: comorbidities (odds ratio [OR]: 2.87; 95% confidence interval [CI], 2.58-3.18), age, and primary insurance. However, the impact of insurance depended on age. For 3- to 5-year-old children, those on Medicaid were more likely to be prescribed psychotropic medications than those with private insurance (OR: 1.65; 95% CI, 1.29-2.12). This was particularly true for alpha-2-adrenergic agonists (OR: 2.48; 95% CI, 1.56-3.92) and atypical antipsychotics (OR: 2.57; 95% CI, 1.46-4.55).Conclusion: There are large variations in prescribing psychotropic medication to children with ASD at 3 academic DBP programs. Further research is needed to understand factors that contribute to higher use of psychotropic medication in young children with Medicaid.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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