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Datapoints: Use of Multiple Psychotropic Drugs by Medicaid-Insured and Privately Insured Children

2002; American Psychiatric Association; Volume: 53; Issue: 12 Linguagem: Inglês

10.1176/appi.ps.53.12.1508

1557-9700

Andrés Martin, Tierney Sherwin, Dorothy Stubbe, Thomas Van Hoof, Lawrence David Scahill, Douglas Leslie,

Youth Substance Use and School Attendance

Back to table of contents Previous article Next article ColumnsFull AccessDatapoints: Use of Multiple Psychotropic Drugs by Medicaid-Insured and Privately Insured ChildrenAndrés Martin, M.D., M.P.H., Tierney Sherwin, M.P.A., Dorothy Stubbe, M.D., Thomas Van Hoof, M.A., M.D., Lawrence Scahill, M.S.N., Ph.D., and Douglas Leslie, Ph.D.Andrés Martin, M.D., M.P.H., Tierney Sherwin, M.P.A., Dorothy Stubbe, M.D., Thomas Van Hoof, M.A., M.D., Lawrence Scahill, M.S.N., Ph.D., and Douglas Leslie, Ph.D.Published Online:1 Dec 2002https://doi.org/10.1176/appi.ps.53.12.1508AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail An increase in the prescription of combinations of psychotropic drugs to children has been documented in recent studies based on large nationally representative samples. This trend stands in sharp contrast with the paucity of empirical information to support this treatment pattern.No published studies have addressed combination treatments. To that end, we analyzed 1999 data from two sources: the Medicaid Managed Care (MMC) database, maintained by the Connecticut Department of Social Services, and MEDSTAT's MarketScan database, which compiles nationwide claims information from private health insurance plans of large employers.As depicted in Figure 1, the rate of psychotropic drug use was approximately double among the Medicaid-enrolled children. The higher prevalence in the older group is consistent with epidemiologic data and reflects the greater use of stimulants among school-age children. As shown in Figure 2, the rate of multiple psychotropic pharmacotherapy was also higher in the Medicaid population. (It should be noted that there is a tenfold difference in the vertical scale for the two figures.)A larger proportion of Medicaid-enrolled children were given prescriptions for multiple psychotropics—even as fewer of them received outpatient mental health services. This finding suggests that they were treated more aggressively. The differences may be related to more severe psychopathology or psychosocial adversity; to variation in coverage for medications, copayment structure, or practice practices across treatment settings; or to other unmeasured plan-specific characteristics.Dr. Martin Dr. Stubbe, Dr. Scahill, and Dr. Leslie are affiliated with the Yale University School of Medicine, 230 South Frontage Road, P.O. Box 207900, New Haven, Connecticut 06520-7900 (e-mail, [email protected]). Ms. Sherwin and Dr. Van Hoof are with Qualidigm in Middletown, Connecticut. Harold A. Pincus, M.D. and Terri L. Tanielian, M.A., are editors of this column.Figure 1. Use of any psychotropic drug by Medicaid-insured and privately insured childrenFigure 2. Use of multiple psychotropic drugs by Medicaid-insured and privately insured children FiguresReferencesCited byDetailsCited byAppropriateness of psychopharmacological therapies to psychiatric diagnoses in persons with autism spectrum disorder with or without intellectual disabilities: a cross-sectional analytic study21 January 2023 | Expert Opinion on Drug Safety, Vol. 15Rates of psychotropic medicine prescribing in paediatric populations in Australian general practice from 2000-2016European Neuropsychopharmacology, Vol. 65Medication Use in the Management of Comorbidities Among Individuals With Autism Spectrum Disorder From a Large Nationwide Insurance DatabaseJAMA Pediatrics, Vol. 175, No. 9JAMA Pediatrics, Vol. 172, No. 6Administration and Policy in Mental Health and Mental Health Services Research, Vol. 42, No. 2Journal of Child and Adolescent Psychopharmacology, Vol. 25, No. 2Pharmacoepidemiology of Psychotropic Medications in Youth17 February 2012Multiple Psychiatric Diagnoses Common in Privately Insured Children on Atypical Antipsychotics28 January 2010 | Clinical Pediatrics, Vol. 49, No. 5Journal of Autism and Developmental Disorders, Vol. 40, No. 3Psychotropic Medication Patterns Among Youth in Foster Care1 January 2008 | Pediatrics, Vol. 121, No. 1Psychiatric Quarterly, Vol. 77, No. 4Journal of Child and Adolescent Psychopharmacology, Vol. 15, No. 1Journal of Child and Adolescent Psychopharmacology, Vol. 15, No. 1Journal of Child and Adolescent Psychopharmacology, Vol. 15, No. 1Journal of the American Academy of Child & Adolescent Psychiatry, Vol. 44, No. 2Journal of the American Academy of Child & Adolescent Psychiatry, Vol. 44, No. 6Comparative Prevalence of Psychotropic Medications Among Youths Enrolled in the SCHIP and Privately Insured YouthsDaniel J. Safer, M.D., Julie Magno Zito, Ph.D., and James F. Gardner, Sc.M.1 September 2004 | Psychiatric Services, Vol. 55, No. 9Psychiatric Inpatient, Outpatient, and Medication Utilization and Costs Among Privately Insured Youths, 1997–2000Andrés Martin, M.D., M.P.H., and Douglas Leslie, Ph.D.1 April 2003 | American Journal of Psychiatry, Vol. 160, No. 4 Volume 53Issue 12 December 2002Pages 1508-1508 Metrics PDF download History Published online 1 December 2002 Published in print 1 December 2002