Evidence map›Paper›PMID 28708433›Full record

ArticleJournal of child and adolescent psychopharmacology2017

Physical Health Outcomes in Preschoolers with Prior Authorization for Antipsychotics.

Yu-Jung Wei, Xinyue Liu, Nikhil Rao, Marie McPherson, Mary Beth Jones, Regina Bussing, Almut G Winterstein

Open access · greenAbstract read
In one paragraph

Article in Journal of child and adolescent psychopharmacology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
0.4field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Yu-Jung Wei1 Department of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy , Gainesville, Florida.
Xinyue Liu1 Department of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy , Gainesville, Florida.
Nikhil Rao2 Department of Psychiatry, University of Florida College of Medicine , Gainesville, Florida.
Marie McPherson3 Florida Mental Health Institute, University of South Florida , Tampa, Florida.
Mary Beth Jones4 Florida Agency for Health Care Administration , Tallahassee, Florida.
Regina Bussing2 Department of Psychiatry, University of Florida College of Medicine , Gainesville, Florida.
Almut G Winterstein1 Department of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy , Gainesville, Florida.
University of Florida · USFlorida Agency for Health Care Administration · USUniversity of South Florida · US

Funding

University of Florida Older Americans Independence Center (OAIC)P30AG028740 · NIA · UNIVERSITY OF FLORIDA · PI CHRISTIAAN LEEUWENBURGH · 2007 to 2026
$22.8M
NIA NIH HHS P30 AG028740
6 · The paper itself

Abstract

objectiveTo examine incidence of adverse health outcomes and associated factors among preschoolers (under age 6) who received antipsychotic treatment through the Florida Medicaid Prior Authorization (PA) program.

methodsUsing Florida's PA registry linked to the state's Medicaid claims data, we ascertained incident outcomes during PA-approved antipsychotic use between April 2008 and September 2015 (7.5 years). Six outcomes associated with use of antipsychotics included: diabetes, obesity, hyperlipidemia, hyperprolactinemia, cardiovascular disease (CVD) (including hypertension, ventricular arrhythmia, and other CVDs), and extrapyramidal symptoms (EPS) (including dystonia, akathisia, parkinsonism, and tardive dyskinesia). Outcome-specific incidences were stratified by short-term (≤1 year) and long-term (>1-7 years) antipsychotic use. We used multivariate modified Poisson regressions to determine factors associated with these outcomes among preschoolers.

resultsThe overall crude incidence during PA-approved antipsychotic use was highest for EPS and obesity (57 and 19 cases/1000 children-years, respectively). The rate of these two outcomes differed by duration of antipsychotic use. We observed a higher obesity (23.8 vs. 9.6, p < 0.001) and dystonia incidence (7.2 vs. 2.5, p < 0.05), but lower akathisia incidence (44.4 vs. 60.6, p < 0.05) among long-term antipsychotic users compared with short-term users. Five outcomes-ventricular arrhythmia, other cardiovascular side effects, hyperprolactinemia, parkinsonism, and tardive dyskinesia-occurred rarely (<2.0/1000 children-years). Preschoolers who were younger at baseline (≤2 years old vs. 4-5 years old) and Black (vs. White) were at a higher risk of EPS.

conclusionRisk for EPS and obesity deserves clinical attention during antipsychotic treatment among preschoolers. Controlled studies that allow interpretation of these incidence rates in the context of background risk and that formally quantify the incremental risk associated with antipsychotic initiation during early childhood are needed.

Indexed as

MedicaidAkathisia, Drug-InducedAntipsychotic AgentsChild, PreschoolDyskinesia, Drug-InducedFemaleFloridaHumansIncidenceLongitudinal StudiesMaleMental DisordersObesityRetrospective StudiesRisk FactorsTime FactorsAntipsychotic Agentsantipsychoticsphysical health outcomespreschoolersprior authorization

Identifiers

PMID28708433
PMCPMC5824663
OpenAlexW2734731372

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.