Trends in Antipsychotic Medication Use in Young Privately Insured Children.
antipsychotic agents
child
drug utilization
off-label use
trends
Journal
Journal of the American Academy of Child and Adolescent Psychiatry
ISSN: 1527-5418
Titre abrégé: J Am Acad Child Adolesc Psychiatry
Pays: United States
ID NLM: 8704565
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
received:
01
06
2020
revised:
16
09
2020
accepted:
13
10
2020
pubmed:
23
10
2020
medline:
22
7
2021
entrez:
22
10
2020
Statut:
ppublish
Résumé
To estimate trends of annual antipsychotic medication use by privately insured young children (aged 2-7 years) in the United States, and to describe the clinical and treatment characteristics of these children. The study population included young children from a nationwide commercial claims database (2007-2017). We estimated annual antipsychotic use by age and sex, defined as the number of children dispensed an antipsychotic per year divided by the number enrolled. We described clinical diagnoses and mental health service use in those with prescription antipsychotic use in 2009 and 2017. Annual antipsychotic use in young children was 0.27% in 2007, peaked at 0.29% in 2009, and statistically significantly declined to 0.17% by 2017 (linear trend: -0.017% per year, 95% CI: -0.018 to -0.016). Antipsychotic use was higher in boys than in girls. A greater proportion of antipsychotic users received a mental disorder diagnosis in 2017 (89%) than in 2009 (86%, p < .01). The most common clinical diagnoses in antipsychotic users, under a hierarchical classification, were pervasive developmental disorder (2009 = 27%, 2017 = 38%, p < .01), conduct or disruptive behavior disorder (2009 = 15%, 2017 = 21%, p < .01), and attention-deficit/hyperactivity disorder (2009 = 24%, 2017 = 18%, p < .01). Among 2017 antipsychotic users, 32% had 4+ psychotherapy claims, 43% had a psychiatrist visit, and the majority used another psychotropic medication, most commonly a stimulant (boys = 57%, girls = 50%). In privately insured young children, antipsychotic use declined from 2009 to 2017, with shifts toward indications with some supporting evidence. Nevertheless, a majority of use remains off label and for conditions lacking effectiveness and safety data. Improving antipsychotic prescribing in young children remains a challenge.
Identifiants
pubmed: 33091567
pii: S0890-8567(20)31987-0
doi: 10.1016/j.jaac.2020.09.023
pmc: PMC8055725
mid: NIHMS1639281
pii:
doi:
Substances chimiques
Antipsychotic Agents
0
Psychotropic Drugs
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Langues
eng
Sous-ensembles de citation
IM
Pagination
877-886Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR003017
Pays : United States
Organisme : NIMH NIH HHS
ID : T32 MH013043
Pays : United States
Organisme : AHRQ HHS
ID : R18 HS023258
Pays : United States
Organisme : NIDA NIH HHS
ID : R01 DA047347
Pays : United States
Organisme : AHRQ HHS
ID : R01 HS026001
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2020 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.
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