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Open Access 01-12-2021 | Care | Research

High-level psychotropic polypharmacy: a retrospective comparison of children in foster care to their peers on Medicaid

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

Published in: BMC Psychiatry | Issue 1/2021

Abstract

Background

The use of antipsychotic medication and psychotropic polypharmacy has increased in the United States over the last two decades especially for children from low-income families and those in foster care. Although attention has been paid to providing greater insight, prescribing patterns remain concerning since there is a lack of evidence related to safety and efficacy. High-level psychotropic polypharmacy has not been described. We aim to compare the use of HLPP for children receiving Medicaid services and those in foster care and identify factors associated with the duration of use of high-level psychotropic polypharmacy. Additionally, we will examine the frequency of laboratory metabolic screening and emergency department, inpatient, and outpatient visits.

Methods

A cross-sectional, secondary analysis of statewide data describes trends in high-level psychotropic polypharmacy from 2012 to 2017 and the prevalence and predictors of high-level psychotropic polypharmacy duration and resource use in 2017 for all children on Medicaid and those in foster care. High-level psychotropic polypharmacy included concurrent use, at least four classes of medications including an antipsychotic, and at least 30 days duration.

Results

High-level psychotropic polypharmacy increased from 2012 to 2014 for both groups but stabilized in 2015–2016. Children in foster care showed a slight increase compared to their peers in 2017. There was no association between duration and demographic characteristics or foster care status. Diagnoses predicted duration. Neither group received metabolic monitoring at an acceptable rate.

Conclusions

Concerning patterns of high-level psychotropic polypharmacy and metabolic monitoring were identified. Cautious use of high-level psychotropic polypharmacy and greater oversight to ensure that these children are receiving comprehensive services like behavioral health, primary care, and primary prevention.

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Title: High-level psychotropic polypharmacy: a retrospective comparison of children in foster care to their peers on Medicaid
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
Publication date: 01-12-2021
Publisher: BioMed Central
Keyword: Care
Published in: BMC Psychiatry / Issue 1/2021
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/s12888-021-03309-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

High-level psychotropic polypharmacy: a retrospective comparison of children in foster care to their peers on Medicaid

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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