Age-Related Trends in Psychotropic Medication Use Among Very Young Children in Foster Care

dosReis, Susan; Tai, Ming Hui; Goffman, David; Lynch, Seán; Reeves, Gloria; Shaw, Terry V.

doi:10.1176/appi.ps.201300353

Cited by 23 publications

(21 citation statements)

References 18 publications

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“…Some researchers have argued that psychotropic prescribing patterns for children and adolescents have exceeded the support of clinical research and are beyond the evidence for demonstrating safety and efficacy (Baker, 2018; Bogler et al, 2019; Brenner et al, 2014). To this end, some researchers have called for a reduction in the use of psychotropic medication to treat young children and an increase in studies to evaluate the effect of chronic exposure of such medication on children’s health (dosReis et al, 2014).…”

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confidence: 99%

“…dosReis et al (2014) conducted a retrospective analysis of psychotropic medication records for a sample of nearly 1,500 foster youth aged 6 years or younger who resided in foster care for at least 1 year. Overall, dosReis et al found that 12% of the children received at least one psychotropic medication over a 3-year period.…”

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confidence: 99%

“…In summary, findings from multiple studies suggest prescribing practices for psychotropic medications with children are highly variable. The absence of systematic evaluations of medication discontinuation in the youth-specific research literature is a parallel concern (Baker, 2018; Bogler et al, 2019; dosReis et al, 2014; Grudnikoff & Bellonci, 2017). Although some states have published guidelines for the use of psychotropic medication with foster children, to our knowledge, no study has directly evaluated the deprescribing of psychotropic medication for children in foster care.…”

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Do prescribers deprescribe psychotropic medication for children in foster care?

O’Brien

Rapp

Kierce

2020

Developmental Child Welfare

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Approximately one third of children in foster care in the U.S. receive psychotropic medication; however, few studies have evaluated the extent to which either the number or dosage of drugs changes across time. We conducted a retrospective descriptive study of Medicaid files for 30 individuals placed in a foster care system that included an analysis of 10 consecutive visits with a prescribing practitioner spanning 8–14 months. Specifically, we evaluated the data for evidence of deprescribing. Results indicate practitioners changed psychotropic medication during 70% of visits and most changes involved removing and adding psychotropic medication within the same class. Results also show 60% of visits across participants involved prescriptions for four or more psychotropic medications, whereas only 0.33% of trials involved no psychotropic medication. Furthermore, results show the mean number of psychotropic medications per foster child at the end of the study ( M = 3.97) did not decrease in comparison to the start of the study ( M = 3.53). Taken together, these results indicate that prescribers do not regularly engage in a clear deprescribing process for psychotropic medication when serving foster youth. We discuss some limitations to the current study and directions for future research on prescribing patterns with foster children.

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confidence: 99%

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Do prescribers deprescribe psychotropic medication for children in foster care?

O’Brien

Rapp

Kierce

2020

Developmental Child Welfare

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“…Já Bronsard et al (2016), numa metanálise da prevalência de perturbações mentais das crianças e jovens no sistema de proteção, maioritariamente com medida de colocação, estimaram um valor de 49%. De uma forma geral, na investigação neste domínio, os problemas mais frequentemente identificados foram a perturbação de hiperatividade e défice de atenção (PHDA), perturbação de oposição e desafio, depressão, ansiedade e perturbação de stress pós traumático (PTSD) (Desjardins et al, 2017;DosReis et al, 2014;Green, Hawkins e Hawkins, 2005;Linares, Martinez-Martin e Castellanos, 2013;McAuley e Davis, 2009;Narendorf, Bertram e McMillen, 2011).…”

Section: Psicopatologia De Crianças E Jovens Em Contexto Institucionalunclassified

“…Há evidência de que o uso deste tipo de medicamentos é muito frequente neste grupo de crianças e jovens (Zito et al, 2008), sendo duas a três vezes mais elevado comparativamente com a população em geral (Raghavan, Zima, Andersen, Leibowitz, Schuster e Landsverk, 2005). Os diferentes estudos que incidem na prescrição de psicofármacos para este grupo populacional apresentam uma grande amplitude de resultados, entre 12 e 77 % (Brenner et al, 2014;Desjardins, Lafortune e Cyr, 2017;DosReis et al, 2014;Green, Hawkins e Hawkins, 2005;Linares, Martinez-Martin e Castellanos, 2013), podendo esta amplitude de resultados decorrer do tamanho das amostras selecionadas. Em Portugal, de acordo com os relatórios CASA (ISS, 2016; 2017), em 2015, 23,4% das crianças e adolescentes estavam medicados, tendo essa percentagem diminuído para 20%, em 2016.…”

Section: Do Diagnóstico Psicopatológico à Intervenção Farmacológicaunclassified

Saúde mental e utilização de psicofármacos em crianças e jovens em regime de acolhimento residencial em Portugal – um estudo exploratório

Pires¹,

Martins²

2019

configuracoes

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Acolhimento de Crianças e Jovens Saúde mental e utilização de psicofármacos em crianças e jovens em regime de acolhimento residencial em Portugal-um estudo exploratório Mental health and Psychotropic Medication Use among Children and Young People in Residential Care-An exploratory study La santé mentale et l'utilisation des médicaments psychotropes chez les enfants les jeunes placés en institutions-une étude exploratoire

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Association Between State-Level Criminal Justice–Focused Prenatal Substance Use Policies in the US and Substance Use–Related Foster Care Admissions and Family Reunification

Sanmartin

Ali

Lynch³

et al. 2020

JAMA Pediatr

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IMPORTANCEStates have enacted criminal justice-related substance use policies to address prenatal substance use and protect infants from adverse health effects of parental substance use. However, little is known about the consequences of these policies for permanency outcomes among infants in the foster care system in the United States.OBJECTIVES To evaluate the consequences of criminal justice-related prenatal substance use policies for family reunification and to examine differences in parental reunification by racial/ethnic group. DESIGN, SETTING, AND PARTICIPANTSIn this cohort study using data from the 2005 to 2017 Adoption and Foster Care Analysis and Reporting System, 13 cohorts of infants who entered the foster care system were followed up. States with criminal justice-related prenatal substance use policies were compared with states without such policies before and after their enactment using a discrete-time hazard model adjusted for individual covariates, state, and cohort fixed effects. The sample consisted of 350 604 infants 1 year or younger who had been removed from their home because of parental drug or alcohol use. MAIN OUTCOMES AND MEASURESLength of time from entering the child welfare system to first reunification with a parent and hazard rates (HRs). RESULTSOf the 350 604 infants 1 year or younger, 182 314 (52%) were boys, 251 572 (72%) were non-Hispanic white children, and 160 927 (46%) lived in US states with a criminal justice-focused prenatal substance use policy. Among those who were reunified, 36% of the reunifications occurred during the first year and 45% in the second year. Foster care infants who were removed from their homes because of parental substance use who live in states that have adopted criminal justice-oriented policies had a lower chance of reunification with a parent compared with states that have not adopted those policies (HR, 0.95; 95% CI, 0.94-0.96). Specifically, non-Hispanic black children who live in a state that has adopted criminal justice-oriented policies had a lower chance of reunification with a parent than non-Hispanic black children who live in a state that has not adopted those policies (HR, 0.87; 95% CI, 0.81-0.94). CONCLUSIONS AND RELEVANCEGiven the child welfare system's legal mandate to make every effort toward parental reunification, a more comprehensive treatment and supportive policy approach toward parental substance use might be warranted.

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Age-Related Trends in Psychotropic Medication Use Among Very Young Children in Foster Care

Abstract: Young children who initiated antipsychotic and ADHD medications before the age of six continued to receive them for longer periods of time. There is a critical need for long-term studies to evaluate the effect of chronic exposure on children's health and well-being.

Cited by 23 publications

References 18 publications

Do prescribers deprescribe psychotropic medication for children in foster care?

Do prescribers deprescribe psychotropic medication for children in foster care?

Saúde mental e utilização de psicofármacos em crianças e jovens em regime de acolhimento residencial em Portugal – um estudo exploratório

Association Between State-Level Criminal Justice–Focused Prenatal Substance Use Policies in the US and Substance Use–Related Foster Care Admissions and Family Reunification

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