Evidence map›Paper›PMID 36415909›Full record

ArticleJournal of hospital medicine2023

Pharmacologic restraint use for children experiencing mental health crises in pediatric hospitals.

Ryan M Wolf, Matthew Hall, Derek J Williams, Alison R Carroll, James W Antoon, Charlotte M Brown, Alison Herndon, Heather Kreth, Carrie Lind, Kelsey A B Gastineau and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of hospital medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors.

Ryan M WolfDepartment of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt and Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID 0000-0001-8420-936X
Matthew HallChildren's Hospital Association, Lenexa, Kansas, USA.ORCID 0000-0001-7778-5887
Derek J WilliamsDepartment of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt and Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Alison R CarrollDepartment of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt and Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID 0000-0003-4807-7819
James W AntoonDepartment of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt and Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID 0000-0001-6188-2658
Charlotte M BrownDepartment of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt and Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Alison HerndonDepartment of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt and Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID 0000-0002-2749-8705
Heather KrethDepartment of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt and Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Carrie LindDepartment of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt and Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Kelsey A B GastineauDepartment of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt and Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Katherine SpencerDepartment of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt and Vanderbilt University Medical Center, Nashville, Tennessee, USA.
My-Linh NgoDepartment of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt and Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Sarah HartDepartment of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt and Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Lindsay WhiteDepartment of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt and Vanderbilt University Medical Center, Nashville, Tennessee, USA.
David P JohnsonDepartment of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt and Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Funding

Learning Health System training program: PROgRESS--Patient/ pRactice Outcomes and Research in Effectiveness and Systems ScienceT32HS026122 · AHRQ · VANDERBILT UNIVERSITY MEDICAL CENTER · PI GRIJALVA, CARLOS G, ROUMIE, CHRISTIANNE L. · 2018 to 2024
$3.5M
Oseltamivir Use and Risk of Serious Neuropsychiatric Adverse Events in ChildrenK23AI168496 · NIAID · VANDERBILT UNIVERSITY MEDICAL CENTER · PI ANTOON, JAMES W · 2022 to 2025
$740k
AHRQ HHS T32 HS026122AHRQ HHS T32HS026122NIAID NIH HHS K23 AI168496
6 · The paper itself

Abstract

backgroundChildren in mental health crises are increasingly admitted to children's hospitals awaiting inpatient psychiatric placement. During hospitalization, patients may exhibit acute agitation prompting pharmacologic restraint use.

objectiveTo determine hospital-level incidence and variation of pharmacologic restraint use among children admitted for mental health conditions in children's hospitals. DESIGN, SETTING, AND

participantsWe examined data for children (5 to ≤18 years) admitted to children's hospitals with a primary mental health condition from 2018 to 2020 using the Pediatric Health Information System database. Hospital rates of parenteral pharmacologic restraint use per 1000 mental health bed days were determined and compared after adjusting for patient-level and demographic factors. Cluster analysis (k-means) was used to group hospitals based on overall restraint use (rate quartiles) and drug class. Hospital-level factors for pharmacologic restraint use were compared.

resultsOf 29,834 included encounters, 3747 (12.6%) had pharmacologic restraint use. Adjusted hospital rates ranged from 35 to 389 pharmacologic restraint use days per 1000 mental health bed days with a mean of 175 (standard deviation: 72). Cluster analysis revealed three hospitals were high utilizers of all drug classes. No significant differences in pharmacologic restraint use were found in the hospital-level analysis.

conclusionsChildren's hospitals demonstrate wide variation in pharmacologic restraint rates for mental health hospitalizations, with a 10-fold difference in adjusted rates between highest and lowest utilizers, and high overall utilizers order medications across all drug classes.

Indexed as

Mental DisordersMental HealthAnxietyChildHospitalizationHospitals, PediatricHumansRetrospective Studies

Identifiers

PMID36415909
PMCPMC9899307

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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.