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Erschienen in: Community Mental Health Journal 1/2018

31.03.2017 | Original Paper

Providers’ Behaviors and Beliefs on Prescribing Antipsychotic Medication to Children: A Qualitative Study

verfasst von: W. David Lohr, Kyle B. Brothers, Deborah Winders Davis, Carla A. Rich, Lesa Ryan, Michael Smith, Michelle Stevenson, Yana Feygin, Charles Woods, John Myers, Gilbert C. Liu

Erschienen in: Community Mental Health Journal | Ausgabe 1/2018

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Abstract

Fragmentation in behavioral and mental health care to children has resulted in suboptimal care and high rates of psychotropic medication use, especially antipsychotic medications (APM). A qualitative study, based on the Theory of Planned Behavior (TPB), aimed to better understand prescribing practices, barriers to optimal treatment, and potential interventions to safeguard the use of APM for children in Kentucky. The most common barrier to optimal care was access to mental health specialists. Social norms and pressure from families contribute to increased medication use. We identify promising interventions to safeguard the use of APM through the lens of the TPB.
Literatur
Zurück zum Zitat Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Decision Making Processes, 50, 179–211.CrossRef Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Decision Making Processes, 50, 179–211.CrossRef
Zurück zum Zitat Almandil, N. B., Liu, Y., Murray, M. L., Besag, F. M., Aitchison, K. J., & Wong, I. C. (2013). Weight gain and other metabolic adverse effects associated with atypical antipsychotic treatment of children and adolescents: A systematic review and meta-analysis. Paediatric Drugs, 15(2), 139–150.CrossRef Almandil, N. B., Liu, Y., Murray, M. L., Besag, F. M., Aitchison, K. J., & Wong, I. C. (2013). Weight gain and other metabolic adverse effects associated with atypical antipsychotic treatment of children and adolescents: A systematic review and meta-analysis. Paediatric Drugs, 15(2), 139–150.CrossRef
Zurück zum Zitat American Academy of Child & Adolescent Psychiatry. (2009). Practice parameter on the use of psychotropic medication in children and adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 48(9), 961–973. doi:10.1097/CHI.0b013e3181ae0a08.CrossRef American Academy of Child & Adolescent Psychiatry. (2009). Practice parameter on the use of psychotropic medication in children and adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 48(9), 961–973. doi:10.​1097/​CHI.​0b013e3181ae0a08​.CrossRef
Zurück zum Zitat Arango, C., Giraldez, M., Merchan-Naranjo, J., Baeza, I., Castro-Fornieles, J., Alda, J. A., et al. (2014). Second-generation antipsychotic use in children and adolescents: a six-month prospective cohort study in drug-naive patients. Journal of the American Academy of Child & Adolescent Psychiatry, 53(11), 1179–1190. doi:10.1016/j.jaac.2014.08.009.CrossRef Arango, C., Giraldez, M., Merchan-Naranjo, J., Baeza, I., Castro-Fornieles, J., Alda, J. A., et al. (2014). Second-generation antipsychotic use in children and adolescents: a six-month prospective cohort study in drug-naive patients. Journal of the American Academy of Child & Adolescent Psychiatry, 53(11), 1179–1190. doi:10.​1016/​j.​jaac.​2014.​08.​009.CrossRef
Zurück zum Zitat Becker, E. R., Constantine, R. J., McPherson, M. A., & Jones, M. E. (2013). Antipsychotic polypharmacy prescribing patterns and costs in the Florida adult and child Medicaid populations. Journal of Health Care Finance, 40(1), 40–67.PubMed Becker, E. R., Constantine, R. J., McPherson, M. A., & Jones, M. E. (2013). Antipsychotic polypharmacy prescribing patterns and costs in the Florida adult and child Medicaid populations. Journal of Health Care Finance, 40(1), 40–67.PubMed
Zurück zum Zitat Bobo, W. V., Cooper, W. O., Stein, C. M., Olfson, M., Graham, D., Daugherty, J., et al. (2013). Antipsychotics and the risk of type 2 diabetes mellitus in children and youth. JAMA Psychiatry, 70(10), 1067–1075.CrossRef Bobo, W. V., Cooper, W. O., Stein, C. M., Olfson, M., Graham, D., Daugherty, J., et al. (2013). Antipsychotics and the risk of type 2 diabetes mellitus in children and youth. JAMA Psychiatry, 70(10), 1067–1075.CrossRef
Zurück zum Zitat Carbon, M., Kapoor, S., Sheridan, E., Al-Jadiri, A., Azzo, S., Sarkaria, T., et al. (2015). Neuromotor adverse effects in 342 youth during 12 weeks of naturalistic treatment with 5 s-generation antipsychotics. Journal of the American Academy of Child & Adolescent Psychiatry, 54(9), 718–727. doi:10.1016/j.jaac.2015.06.015.CrossRef Carbon, M., Kapoor, S., Sheridan, E., Al-Jadiri, A., Azzo, S., Sarkaria, T., et al. (2015). Neuromotor adverse effects in 342 youth during 12 weeks of naturalistic treatment with 5 s-generation antipsychotics. Journal of the American Academy of Child & Adolescent Psychiatry, 54(9), 718–727. doi:10.​1016/​j.​jaac.​2015.​06.​015.CrossRef
Zurück zum Zitat Carpenter-Song, E., & Snell-Rood, C. (2016). The changing context of rural America: A call to examine the impact of social change on mental health and mental health care. Psychiatric Services, appips201600024. doi:10.1176/appi.ps.201600024.CrossRef Carpenter-Song, E., & Snell-Rood, C. (2016). The changing context of rural America: A call to examine the impact of social change on mental health and mental health care. Psychiatric Services, appips201600024. doi:10.​1176/​appi.​ps.​201600024.CrossRef
Zurück zum Zitat Correll, C. U., Manu, P., Olshanskiy, V., Napolitano, B., Kane, J. M., & Malhotra, A. K. (2009). Cardiometabolic risk of second-generation antipsychotic medications during first-time use in children and adolescents. JAMA: The Journal of the American Medical Association, 302(16), 1765–1773. doi:10.1001/jama.2009.1549.CrossRefPubMed Correll, C. U., Manu, P., Olshanskiy, V., Napolitano, B., Kane, J. M., & Malhotra, A. K. (2009). Cardiometabolic risk of second-generation antipsychotic medications during first-time use in children and adolescents. JAMA: The Journal of the American Medical Association, 302(16), 1765–1773. doi:10.​1001/​jama.​2009.​1549.CrossRefPubMed
Zurück zum Zitat Davis, D. W., Smith, M. J., Feygin, Y., Myers, J., Lohr, D., Collins-Camargo, C., Williams, P. G., Jones, V. F. (2016). Medication prescribing to children insured by Kentucky Medicaid interim report December 2016. Unpublished data analysis. Pediatrics. University of Louisville. Louisville, KY. Davis, D. W., Smith, M. J., Feygin, Y., Myers, J., Lohr, D., Collins-Camargo, C., Williams, P. G., Jones, V. F. (2016). Medication prescribing to children insured by Kentucky Medicaid interim report December 2016. Unpublished data analysis. Pediatrics. University of Louisville. Louisville, KY.
Zurück zum Zitat De Hert, M., Dobbelaere, M., Sheridan, E. M., Cohen, D., & Correll, C. U. (2011). Metabolic and endocrine adverse effects of second-generation antipsychotics in children and adolescents: A systematic review of randomized, placebo controlled trials and guidelines for clinical practice. European Psychiatry, 26(3), 144–158. doi:10.1016/j.eurpsy.2010.09.011.CrossRefPubMed De Hert, M., Dobbelaere, M., Sheridan, E. M., Cohen, D., & Correll, C. U. (2011). Metabolic and endocrine adverse effects of second-generation antipsychotics in children and adolescents: A systematic review of randomized, placebo controlled trials and guidelines for clinical practice. European Psychiatry, 26(3), 144–158. doi:10.​1016/​j.​eurpsy.​2010.​09.​011.CrossRefPubMed
Zurück zum Zitat Findling, R., Drury, S., Jensen, P., & Rappaport, J. (2011). Practice parameter for the use of atypical antipsychotic medications in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP). Washington, D.C. Findling, R., Drury, S., Jensen, P., & Rappaport, J. (2011). Practice parameter for the use of atypical antipsychotic medications in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP). Washington, D.C.
Zurück zum Zitat Fraguas, D., Correll, C. U., Merchan-Naranjo, J., Rapado-Castro, M., Parellada, M., Moreno, C., et al. (2011). Efficacy and safety of second-generation antipsychotics in children and adolescents with psychotic and bipolar spectrum disorders: Comprehensive review of prospective head-to-head and placebo-controlled comparisons. European Neuropsychopharmacology, 21(8), 621–645. doi:10.1016/j.euroneuro.2010.07.002.CrossRefPubMed Fraguas, D., Correll, C. U., Merchan-Naranjo, J., Rapado-Castro, M., Parellada, M., Moreno, C., et al. (2011). Efficacy and safety of second-generation antipsychotics in children and adolescents with psychotic and bipolar spectrum disorders: Comprehensive review of prospective head-to-head and placebo-controlled comparisons. European Neuropsychopharmacology, 21(8), 621–645. doi:10.​1016/​j.​euroneuro.​2010.​07.​002.CrossRefPubMed
Zurück zum Zitat Friedman, R. M., & Kutash, K. (1992). Challenges for child and adolescent mental health. Health Affairs, 11(3), 125–136.CrossRef Friedman, R. M., & Kutash, K. (1992). Challenges for child and adolescent mental health. Health Affairs, 11(3), 125–136.CrossRef
Zurück zum Zitat Hilt, R. J., Romaire, M. A., McDonell, M. G., Sears, J. M., Krupski, A., Thompson, J. N., et al. (2013). The partnership access line: Evaluating a child psychiatry consult program in Washington State. JAMA Pediatrics, 167(2), 162–168.CrossRef Hilt, R. J., Romaire, M. A., McDonell, M. G., Sears, J. M., Krupski, A., Thompson, J. N., et al. (2013). The partnership access line: Evaluating a child psychiatry consult program in Washington State. JAMA Pediatrics, 167(2), 162–168.CrossRef
Zurück zum Zitat Hilt, R. J., Barclay, R. P., Bush, J., Stout, B., Anderson, N., & Wignall, J. R. (2015). A statewide child telepsychiatry consult system yields desired health system changes and savings. Telemedicine Journal and E-health: The Official Journal of the American Telemedicine Association, 21(7), 533–537. doi:10.1089/tmj.2014.0161.CrossRef Hilt, R. J., Barclay, R. P., Bush, J., Stout, B., Anderson, N., & Wignall, J. R. (2015). A statewide child telepsychiatry consult system yields desired health system changes and savings. Telemedicine Journal and E-health: The Official Journal of the American Telemedicine Association, 21(7), 533–537. doi:10.​1089/​tmj.​2014.​0161.CrossRef
Zurück zum Zitat Howie, L. D., Pastor, P. N., & Lukacs, S. L. (2014). Use of medication prescribed for emotional or behavioral difficulties among children aged 6–17 years in the United States, 2011–2012: NCHS data brief. Hyattsville, MD: National Center for Health Statistics. Howie, L. D., Pastor, P. N., & Lukacs, S. L. (2014). Use of medication prescribed for emotional or behavioral difficulties among children aged 6–17 years in the United States, 2011–2012: NCHS data brief. Hyattsville, MD: National Center for Health Statistics.
Zurück zum Zitat Knapp, P., Chait, A., Pappadopulos, E., Crystal, S., & Jensen, P. S. (2012). Treatment of maladaptive aggression in youth: CERT guidelines I. Engagement, assessment, and management. Pediatrics, 129(6), e1562–e1576. doi:10.1542/peds.2010-1360.CrossRefPubMed Knapp, P., Chait, A., Pappadopulos, E., Crystal, S., & Jensen, P. S. (2012). Treatment of maladaptive aggression in youth: CERT guidelines I. Engagement, assessment, and management. Pediatrics, 129(6), e1562–e1576. doi:10.​1542/​peds.​2010-1360.CrossRefPubMed
Zurück zum Zitat Lohr, W. D., Chowning, R. T., Stevenson, M. D., & Williams, P. G. (2015). Trends in atypical antipsychotics prescribed to children six years of age or less on Medicaid in Kentucky. Journal of Child and Adolescent Psychopharmacology, 25(5), 440–443. doi:10.1089/cap.2014.0057.CrossRefPubMedPubMedCentral Lohr, W. D., Chowning, R. T., Stevenson, M. D., & Williams, P. G. (2015). Trends in atypical antipsychotics prescribed to children six years of age or less on Medicaid in Kentucky. Journal of Child and Adolescent Psychopharmacology, 25(5), 440–443. doi:10.​1089/​cap.​2014.​0057.CrossRefPubMedPubMedCentral
Zurück zum Zitat Morrato, E. H., Nicol, G. E., Maahs, D., Druss, B. G., Hartung, D. M., Valuck, R. J., et al. (2010). Metabolic screening in children receiving antipsychotic drug treatment. Archives of Pediatric and Adolescent Medicine, 164(4), 344–351. doi:10.1001/archpediatrics.2010.48.CrossRef Morrato, E. H., Nicol, G. E., Maahs, D., Druss, B. G., Hartung, D. M., Valuck, R. J., et al. (2010). Metabolic screening in children receiving antipsychotic drug treatment. Archives of Pediatric and Adolescent Medicine, 164(4), 344–351. doi:10.​1001/​archpediatrics.​2010.​48.CrossRef
Zurück zum Zitat Murphy, A. L., Gardner, D. M., Kisely, S., Cooke, C. A., Kutcher, S. P., & Hughes, J. (2015). System struggles and substitutes: A qualitative study of general practitioner and psychiatrist experiences of prescribing antipsychotics to children and adolescents. Clinical Child Psychology and Psychiatry. doi:10.1177/1359104515617518.CrossRefPubMedPubMedCentral Murphy, A. L., Gardner, D. M., Kisely, S., Cooke, C. A., Kutcher, S. P., & Hughes, J. (2015). System struggles and substitutes: A qualitative study of general practitioner and psychiatrist experiences of prescribing antipsychotics to children and adolescents. Clinical Child Psychology and Psychiatry. doi:10.​1177/​1359104515617518​.CrossRefPubMedPubMedCentral
Zurück zum Zitat Olfson, M., Crystal, S., Huang, C., & Gerhard, T. (2010). Trends in antipsychotic drug use by very young, privately insured children. Journal of the American Academy of Child & Adolescent Psychiatry, 49(1), 13–23. Olfson, M., Crystal, S., Huang, C., & Gerhard, T. (2010). Trends in antipsychotic drug use by very young, privately insured children. Journal of the American Academy of Child & Adolescent Psychiatry, 49(1), 13–23.
Zurück zum Zitat Pope, C., & Mays, N. (2006). Qualitative research in health care. Malden, MA: Blackwell.CrossRef Pope, C., & Mays, N. (2006). Qualitative research in health care. Malden, MA: Blackwell.CrossRef
Zurück zum Zitat Rosato, N. S., Correll, C. U., Pappadopulos, E., Chait, A., Crystal, S., & Jensen, P. S. (2012). Treatment of maladaptive aggression in youth: CERT guidelines II. Treatments and ongoing management. Pediatrics, 129(6), e1577–e1586. doi:10.1542/peds.2010-1361.CrossRef Rosato, N. S., Correll, C. U., Pappadopulos, E., Chait, A., Crystal, S., & Jensen, P. S. (2012). Treatment of maladaptive aggression in youth: CERT guidelines II. Treatments and ongoing management. Pediatrics, 129(6), e1577–e1586. doi:10.​1542/​peds.​2010-1361.CrossRef
Zurück zum Zitat Rubin, D. M., Kreider, A. R., Matone, M., Huang, Y. S., Feudtner, C., Ross, M. E., et al. (2015). Risk for incident diabetes mellitus following initiation of second-generation antipsychotics among Medicaid-enrolled youths. JAMA Pediatrics, 169(4), e150285. doi:10.1001/jamapediatrics.2015.0285.CrossRefPubMed Rubin, D. M., Kreider, A. R., Matone, M., Huang, Y. S., Feudtner, C., Ross, M. E., et al. (2015). Risk for incident diabetes mellitus following initiation of second-generation antipsychotics among Medicaid-enrolled youths. JAMA Pediatrics, 169(4), e150285. doi:10.​1001/​jamapediatrics.​2015.​0285.CrossRefPubMed
Zurück zum Zitat Sarvet, B., Gold, J., Bostic, J. Q., Masek, B. J., Prince, J. B., Jeffers-Terry, M., et al. (2010). Improving access to mental health care for children: The Massachusetts Child Psychiatry Access Project. Pediatrics, 126(6), 1191–1200.CrossRef Sarvet, B., Gold, J., Bostic, J. Q., Masek, B. J., Prince, J. B., Jeffers-Terry, M., et al. (2010). Improving access to mental health care for children: The Massachusetts Child Psychiatry Access Project. Pediatrics, 126(6), 1191–1200.CrossRef
Zurück zum Zitat Seabury, S. A., Goldman, D. P., Kalsekar, I., Sheehan, J. J., Laubmeier, K., & Lakdawalla, D. N. (2014). Formulary restrictions on atypical antipsychotics: impact on costs for patients with schizophrenia and bipolar disorder in Medicaid. American Journal of Managed Care, 20(2), e52–e60.PubMed Seabury, S. A., Goldman, D. P., Kalsekar, I., Sheehan, J. J., Laubmeier, K., & Lakdawalla, D. N. (2014). Formulary restrictions on atypical antipsychotics: impact on costs for patients with schizophrenia and bipolar disorder in Medicaid. American Journal of Managed Care, 20(2), e52–e60.PubMed
Zurück zum Zitat U.S. Department of Health and Human Services. (2013). The U.S. Health Workforce Chartbook Part 4: Behavioral and allied health. Rockville, MD: Health Resources and Services Administration (HRSA) and National Center for Health Workforce Analysis. U.S. Department of Health and Human Services. (2013). The U.S. Health Workforce Chartbook Part 4: Behavioral and allied health. Rockville, MD: Health Resources and Services Administration (HRSA) and National Center for Health Workforce Analysis.
Zurück zum Zitat Zito, J. M., Safer, D. J., Zuckerman, I. H., Gardner, J. F., & Soeken, K. (2005). Effect of Medicaid eligibility category on racial disparities in the use of psychotropic medications among youths. Psychiatric Services, 56(2), 157–163. doi:10.1176/appi.ps.56.2.157.CrossRefPubMed Zito, J. M., Safer, D. J., Zuckerman, I. H., Gardner, J. F., & Soeken, K. (2005). Effect of Medicaid eligibility category on racial disparities in the use of psychotropic medications among youths. Psychiatric Services, 56(2), 157–163. doi:10.​1176/​appi.​ps.​56.​2.​157.CrossRefPubMed
Metadaten
Titel
Providers’ Behaviors and Beliefs on Prescribing Antipsychotic Medication to Children: A Qualitative Study
verfasst von
W. David Lohr
Kyle B. Brothers
Deborah Winders Davis
Carla A. Rich
Lesa Ryan
Michael Smith
Michelle Stevenson
Yana Feygin
Charles Woods
John Myers
Gilbert C. Liu
Publikationsdatum
31.03.2017
Verlag
Springer US
Erschienen in
Community Mental Health Journal / Ausgabe 1/2018
Print ISSN: 0010-3853
Elektronische ISSN: 1573-2789
DOI
https://doi.org/10.1007/s10597-017-0125-8

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