Advancing the Quality of Pediatric Antipsychotic Use: Maybe It Takes a <scp>PAL</scp>

Zito, Julie Magno

doi:10.1111/1475-6773.12671

Cited by 5 publications

(6 citation statements)

References 13 publications

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“…The model created by Washington State was innovative in strategizing for a partnership access telephone line to encourage building relationships between academic psychiatrists and primary care prescribing physicians. Beginning in 2008 with a voluntary telephone access program and advancing to a mandatory program in 2009, the program at its core is educational and emphasizes partnering across specialties to ensure high-quality care (19).…”

Section: Discussionmentioning

confidence: 99%

The Impact of a State Medicaid Peer-Review Authorization Program on Pediatric Use of Antipsychotic Medications

Pennap

Burcu

Safer

et al. 2018

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Section: Discussionmentioning

confidence: 99%

The Impact of a State Medicaid Peer-Review Authorization Program on Pediatric Use of Antipsychotic Medications

Pennap

Burcu

Safer

et al. 2018

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“…However, challenges exist, such as growing use of complex AAP regimens and low uptake of recommended cardiometabolic monitoring . Educationally oriented peer review, as demonstrated in state D, may account for spillover effects among older youth who were not similarly monitored …”

Section: Discussionmentioning

confidence: 99%

Pediatric Use of Antipsychotic Medications Before and After Medicaid Peer Review Implementation

et al. 2018

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“…While the prevalence of prescribed/dispensed medication should be interpreted with care and cannot be considered as overprescribing in general (24), the similarity of these trends is remarkable and the potential drivers of these trends should be carefully examined, andif necessary-addressed. Actually, there are precedents for efforts to establish rational use of APs in children and adolescents and, where appropriate, reduce use for non-psychotic disorders (26,27,38). In the US, monitoring programs and peer-review models have already shown to improve the quality and reduce the prevalence of pediatric AP use (27,(38)(39)(40).…”

Section: Overall Trends In Ap Usementioning

confidence: 99%

“…Despite these potential risks, studies from various countries have observed a questionable increase of AP use among children and adolescents in the last decades (19)(20)(21)(22)(23)(24)(25). This gives cause for concern and has already led to deprescribing initiatives in some countries in order to promote best practice in AP prescribing and to reduce the use of AP in children and adolescents (26)(27)(28).…”

Section: Introductionmentioning

confidence: 99%

Trends in antipsychotic use among children and adolescents in Germany: a study using 2011–2020 nationwide outpatient claims data

Dörks,

Bachmann,

Below

et al. 2023

Front. Psychiatry

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IntroductionWe aimed to provide an update on trends in antipsychotic (AP) use among children and adolescents in Germany.Materials and methodsBased on nationwide outpatient claims data from Germany, we conducted a cross-sectional study. For each year from 2011 to 2020, we determined the prevalence of AP use, defined as the proportion of children and adolescents with at least one AP dispensation. We evaluated trends in AP use by age, sex, and AP class (typical vs. atypical). Additionally, we assessed trends in the specialty of AP prescribers and the frequency of psychiatric diagnoses among AP users.ResultsOverall, data from more than 12 million children and adolescents were included for each calendar year (2011: 12,488,827; 2020: 13,330,836). From 2011 to 2020, the overall prevalence of pediatric AP use increased from 3.16 to 3.65 per 1,000, due to an increase in use of both typical APs (from 1.16 to 1.35 per 1,000) and atypical APs (from 2.35 to 2.75 per 1,000). The largest increase in AP use was found among 15- to 19-year-old females, with an increase from 3.88 per 1,000 in 2011 to 7.86 per 1,000 in 2020 (+103%), mainly due to rising quetiapine use (from 1.17 to 3.46 per 1,000). Regarding prescribers’ specialty, the proportion of APs prescribed by child and adolescent psychiatrists increased during the studied period (2011: 24.8%; 2020: 36.4%), whereas prescriptions by pediatricians (2011: 26.0%; 2020: 19.9%) and general practitioners (2011: 18.0%; 2020: 12.4%) decreased. Risperidone was the most commonly used AP in males, and quetiapine was the leading AP in females, each with the highest prevalence in 15- to 19-year-olds. In male risperidone users in this age group, the most frequent diagnosis was attention-deficit/hyperactivity disorder (50.4%), while in female quetiapine users it was depression (82.0%).DiscussionUse of APs among children and adolescents in Germany has continued to increase over the last decade. The sharp increase in AP use among 15- to 19-year-old females, which is largely due to an increased use of quetiapine, is remarkable. Potential reasons for this increase—e.g., limited access to psychosocial treatments—should be carefully analyzed. Also, the introduction of more restrictive prescribing guidelines might be considered.

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Advancing the Quality of Pediatric Antipsychotic Use: Maybe It Takes a PAL

Cited by 5 publications

References 13 publications

The Impact of a State Medicaid Peer-Review Authorization Program on Pediatric Use of Antipsychotic Medications

The Impact of a State Medicaid Peer-Review Authorization Program on Pediatric Use of Antipsychotic Medications

Pediatric Use of Antipsychotic Medications Before and After Medicaid Peer Review Implementation

Trends in antipsychotic use among children and adolescents in Germany: a study using 2011–2020 nationwide outpatient claims data

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