Psychotropic Medication Use and Polypharmacy Among Children and Adolescents Initiating Intensive Behavioral Therapy for Severe Challenging Behavior

Matthew J. O’Brien; Alexander M. Pauls; Anna M. Cates; Priya D. Larson; Alithea N. Zorn

doi:10.1016/j.jpeds.2024.114056

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Psychotropic Medication Use and Polypharmacy Among Children and Adolescents Initiating Intensive Behavioral Therapy for Severe Challenging Behavior

Journal article

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Peer reviewed

Psychotropic Medication Use and Polypharmacy Among Children and Adolescents Initiating Intensive Behavioral Therapy for Severe Challenging Behavior

Matthew J. O’Brien, Alexander M. Pauls, Anna M. Cates, Priya D. Larson and Alithea N. Zorn

The Journal of pediatrics, Vol.271, 114056

04/12/2024

DOI: 10.1016/j.jpeds.2024.114056

PMID: 38615943

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Abstract

To evaluate the prevalence, trends, and factors associated with psychotropic medication use and polypharmacy among children and adolescents initiating intensive behavioral therapy for severe challenging behavior over a 10-year period. In this retrospective observational study, we examined data from caregiver interviews and patient medical records on the number and types of psychotropic medications prescribed to patients initiating intensive behavioral therapy between January 1, 2013, through December 31, 2022. Trends in medication use and polypharmacy across the 10-year period were analyzed using regression analysis, while differences in demographics and clinical factors for patients with use and polypharmacy were analyzed using non-parametric statistical analysis with odds ratios presented for significant factors. Data from all 302 pediatric patients initiating intensive behavioral therapy across the 10-year period were analyzed. Among all patients and all years, 83.8% were taking at least one psychotropic medication and 68.2% experienced polypharmacy. There were no changes in the prevalence of use, mean number of medications taken, or polypharmacy across the 10-year period. Patients diagnosed with attention-deficit/hyperactivity disorder or anxiety disorder, as well as those exhibiting self-injurious behavior had higher use of psychotropic medication and polypharmacy and were taking more medications overall. Psychotropic medication use and polypharmacy were extremely high for children and adolescents with severe challenging behavior, but use and polypharmacy did not change over the 10-year period of data collection. Further research is needed to establish the generality of these findings to other regions of the US.

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Title: Subtitle: Psychotropic Medication Use and Polypharmacy Among Children and Adolescents Initiating Intensive Behavioral Therapy for Severe Challenging Behavior
Creators: Matthew J. O’Brien - University of Iowa
Alexander M. Pauls - University of Iowa
Anna M. Cates - University of Iowa
Priya D. Larson - University of Iowa
Alithea N. Zorn - University of Iowa
Resource Type: Journal article
Publication Details: The Journal of pediatrics, Vol.271, 114056
DOI: 10.1016/j.jpeds.2024.114056
PMID: 38615943
NLM abbreviation: J Pediatr
ISSN: 0022-3476
eISSN: 1097-6833
Publisher: Elsevier Inc
Language: English
Electronic publication date: 04/12/2024
Academic Unit: Psychiatry; Pediatric Psychology; Stead Family Department of Pediatrics; Epidemiology; Iowa Neuroscience Institute; Psychological and Quantitative Foundations
Record Identifier: 9984586459802771

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