Evidence map›Paper›PMID 34112146›Full record

ArticleBMC psychiatry2021

High-level psychotropic polypharmacy: a retrospective comparison of children in foster care to their peers on Medicaid.

Deborah Winders Davis, W David Lohr, Yana Feygin, Liza Creel, Kahir Jawad, V Faye Jones, P Gail Williams, Jennifer Le, Marie Trace, Natalie Pasquenza

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC psychiatry, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
–field-weighted citation impact
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

12 citing papers in PubMed.

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  11. Assessing and Responding to the Trauma of Child Maltreatment.Focus (American Psychiatric Publishing) · 2022
    Review
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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

10 authors.

Deborah Winders Davis *Department of Pediatrics, Child and Adolescent Health Research Design and Support Unit, University of Louisville, 571 S. Floyd Street, KY, 40202, Louisville, USA. deborah.davis@louisville.edu.
W David Lohr *Department of Pediatrics, Child and Adolescent Health Research Design and Support Unit, University of Louisville, 571 S. Floyd Street, KY, 40202, Louisville, USA. william.lohr@louisville.edu.
Yana FeyginDepartment of Pediatrics, Child and Adolescent Health Research Design and Support Unit, University of Louisville, 571 S. Floyd Street, KY, 40202, Louisville, USA.
Liza CreelDepartment of Health Management & System Sciences, University of Louisville School of Public Health and Information Science, 485 E. Gray Street, Louisville, KY, 40202, USA.
Kahir JawadDepartment of Pediatrics, Child and Adolescent Health Research Design and Support Unit, University of Louisville, 571 S. Floyd Street, KY, 40202, Louisville, USA.
V Faye JonesDepartment of Pediatrics, Child and Adolescent Health Research Design and Support Unit, University of Louisville, 571 S. Floyd Street, KY, 40202, Louisville, USA.
P Gail WilliamsDepartment of Pediatrics, Child and Adolescent Health Research Design and Support Unit, University of Louisville, 571 S. Floyd Street, KY, 40202, Louisville, USA.
Jennifer LeDepartment of Pediatrics, Child and Adolescent Health Research Design and Support Unit, University of Louisville, 571 S. Floyd Street, KY, 40202, Louisville, USA.
Marie TraceDepartment of Pediatrics, Child and Adolescent Health Research Design and Support Unit, University of Louisville, 571 S. Floyd Street, KY, 40202, Louisville, USA.
Natalie PasquenzaDepartment of Pediatrics, Child and Adolescent Health Research Design and Support Unit, University of Louisville, 571 S. Floyd Street, KY, 40202, Louisville, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe use of antipsychotic medication and psychotropic polypharmacy has increased in the United States over the last two decades especially for children from low-income families and those in foster care. Although attention has been paid to providing greater insight, prescribing patterns remain concerning since there is a lack of evidence related to safety and efficacy. High-level psychotropic polypharmacy has not been described. We aim to compare the use of HLPP for children receiving Medicaid services and those in foster care and identify factors associated with the duration of use of high-level psychotropic polypharmacy. Additionally, we will examine the frequency of laboratory metabolic screening and emergency department, inpatient, and outpatient visits.

methodsA cross-sectional, secondary analysis of statewide data describes trends in high-level psychotropic polypharmacy from 2012 to 2017 and the prevalence and predictors of high-level psychotropic polypharmacy duration and resource use in 2017 for all children on Medicaid and those in foster care. High-level psychotropic polypharmacy included concurrent use, at least four classes of medications including an antipsychotic, and at least 30 days duration.

resultsHigh-level psychotropic polypharmacy increased from 2012 to 2014 for both groups but stabilized in 2015-2016. Children in foster care showed a slight increase compared to their peers in 2017. There was no association between duration and demographic characteristics or foster care status. Diagnoses predicted duration. Neither group received metabolic monitoring at an acceptable rate.

conclusionsConcerning patterns of high-level psychotropic polypharmacy and metabolic monitoring were identified. Cautious use of high-level psychotropic polypharmacy and greater oversight to ensure that these children are receiving comprehensive services like behavioral health, primary care, and primary prevention.

Indexed as

MedicaidPolypharmacyChildCross-Sectional StudiesHumansPsychotropic DrugsRetrospective StudiesUnited StatesPsychotropic DrugsChildrenFoster careMedicaidPolypharmacyPsychotropic medications

Identifiers

PMID34112146
PMCPMC8194140

What OpenQuestion holds

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Registered trials

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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.