Study Addresses Appropriate Use of Antipsychotic Medications in Medicaid Children

David C. Rettew, MD Associate Professor of Psychiatry and Pediatrics Director, Child & Adolescent Psychiatry Fellowship     Director, Pediatric Psychiatry Clinic University of Vermont College of MediciMedicalResearch.com Interview with:
David C. Rettew, MD
Associate Professor of Psychiatry and Pediatrics
Director, Child & Adolescent Psychiatry Fellowship
Director, Pediatric Psychiatry Clinic
University of Vermont College of Medicine

Medical Research: What is the background for this study? What are the main findings?

Dr. Rettew: We did this study because while everyone knew that antipsychotic medication rates were going up, there was very little data that drilled deeper and was able to get at the question about the appropriateness of this increase.

There’s good news and bad news in this study.  The bad news is that our data show that about half the time, kids are not being treated with antipsychotic medications according to best practice guidelines.  The good news is that it doesn’t look like these medications are being used casually or in a knee jerk way.  In the vast majority of cases, youth are getting to this class of medications only after many other things have failed.

Medical Research: What should clinicians and patients take away from your report?

Dr. Rettew: I think the bottom line is that I think we could be doing a better job of holding off on these medications until really necessary and monitoring kids taking these medications a little more closely.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Rettew: The article outlines four specific things that could be done that might improve prescribers adherence to best practice guidelines.

  • 1) Improve electronic reminders to doctors about getting recommended labwork
  • 2) Increase availability of counselors who do evidence-based therapy
  • 3) Create a medical record that follows patients better so doctors can know what things have been tried in past for different problems
  • 4) Increase training and consultation to primary care doctors to help them know when and how withdraw these medications appropriately.

Citation:

David C. Rettew, Jeanne Greenblatt, Jody Kamon, Diane Neal, Valerie Harder, Richard Wasserman, Patricia Berry, Charles D. Maclean, Nancy Hogue, and William Mcmains. Antipsychotic Medication Prescribing in Children Enrolled in Medicaid. Pediatrics, March 2015 DOI: 10.1542/peds.2014-2260

 

MedicalResearch.com Interview with:David C. Rettew, MD (2015). Study Addresses Appropriate Use of Antipsychotic Medications in Medicaid Children 

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