Study Confirms Rapid Rise in Antipsychotic Treatment of Medicaid-insured Children
|A new study from the University of Maryland (UM) found that use of
antipsychotic drugs from 1997 to 2006 increased 7- to 12-fold in a
Medicaid population of about 500,000 children ages two to 17.
The study, the latest to confirm a rapid rise of antipsychotics
prescribed among Medicaid-insured children, raises questions about
America's health care system, says lead author Julie Zito, PhD, professor in the UM
School of Pharmacy.
"Many were diagnosed with behavioral rather than psychotic conditions
for which they have FDA-approved labeling," says Zito. "These are often
children with serious socio-economic and family life problems. We need
more information on the benefits and risks of using antipsychotics for
behavioral conditions, such as attention deficit hyperactivity
disorder, ADHD, in community treated populations." Furthermore, use of
antipsychotics in children with Medicaid coverage is five times that of their use in
children in the private sector. This disparity is in need of greater study.
The increased use of antipsychotic medication was most prominent among
youths qualifying by low family income in the state Children's Health
Insurance Program (SCHIP) or through very low income in the Temporary
Assistance for Needy Families (TANF) assistance program. By contrast,
there was less change among the most impaired and vulnerable
youths, those in foster care or those in the Supplemental Security
Income (SSI) program, i.e. youth eligible because of disability.
Zito says, "It raises questions such as 'are the standard treatments
for behavior conditions sufficiently evidence-based in community
populations.' Outcomes research can answer these questions." The
National Institutes of Health website defines outcomes research as
actively engaging in research using existing national survey datasets,
and also supports, develops, and analyzes additional targeted surveys.
The study also found that many of the children received just one or two
prescriptions in the study year and then left treatment. "For a
behavior problem, it means they just didn't come back, so there may
be a continuity problem. This suggests we need more emphasis on
uninterrupted community care. But unfortunately, we have a very
disjointed heath care system."
The Medicaid data set was generated from a representative mid-Atlantic
state. The study appears in the current issue of the journal
Psychiatric Services, by Zito and graduate student Mehmet Burcu, MS, in the School of
Pharmacy's Department of Pharmaceutical Health Services Research;
Laurence S. Magder, PhD, professor and director of Biostatistics
in the UM School of Medicine's, Department of Epidemiology and Public
Health; Aloysius Ibe, DrPH, with the School of Community Health and
Policy, Morgan State University; and Daniel J. Safer, MD, child
psychiatrist with the Departments of Psychiatry and Pediatrics, Johns
|Posting Date: 03/15/2013
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