Plan to Curb Overprescribing of Psychotropic Medications

PolicyLab research laid the groundwork for new statewide initiatives announced in February 2016 that aim to reduce the use of psychotropic medications among Pennsylvania children in the foster care system who are enrolled in Medicaid.

Psychotropic medications are a class of drugs that is used to treat or manage mental health symptoms or challenging behaviors. Antipsychotic medications fall under this category. Since they can have significant side effects, antipsychotics should be prescribed under careful consideration and subject to ongoing monitoring over time.

“There are approved indications for those types of medications, but principally we’ve seen the growth over time in the use of medications like antipsychotics to control disruptive behaviors by in essence sedation,” said David Rubin, MD, MSCE, a pediatrician at The Children’s Hospital of Philadelphia and director of PolicyLab at CHOP.

The research, commissioned by the Pennsylvania Department of Human Services (DHS), had shown that the use of psychotropic medications was three times higher among 6 to 18-year-olds in foster care than among youth in Medicaid overall. More than half of youth antipsychotic users in Medicaid had a diagnosis of attention-deficit/hyperactivity disorder, and a majority of these youth did not have another diagnosis that clinically indicated the use of antipsychotics.

“We think [the combination of guidelines] will have a huge impact on the prescription of psychotropic drugs for children in Pennsylvania, and hopefully it may also be something that folks in other states may want to take a look at,” said DHS Secretary Ted Dallas. “While we’re very happy with the progress we’ve made, we are by no means satisfied. We know there is a lot more to do. Working with our partners at CHOP and PolicyLab, I have no doubt that we’re going to continue to make progress.”

Read the full version of this article in the February 2016 issue of Bench to Bedside.

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