Indiana University, Bloomington.
Indiana University School of Medicine, Indianapolis.
J Am Acad Child Adolesc Psychiatry. 2019 Dec;58(12):1218-1222.e1. doi: 10.1016/j.jaac.2019.06.014. Epub 2019 Jul 30.
There has been growing concern about the safety and efficacy of psychotropic prescribing practices for children enrolled in Medicaid and in foster care. In response, accreditation organizations and policymakers have developed standards for optimal use of psychotropic medications among children. In addition, federal legislation has prompted states to implement monitoring programs to address quality and safety issues among vulnerable pediatric subpopulations. Here, we report findings from an evaluation of Indiana's program for foster youth, which used outlier case review followed by peer-to-peer consultation between prescribing physicians and child and adolescent psychiatrists. We observed clinically and statistically significant reductions in polypharmacy, off-label prescribing, inpatient hospitalizations, health care costs, and related outcomes among youths randomized to an immediate intervention group compared to no improvements in a waitlist control group.
对于参加医疗补助计划和寄养的儿童，精神类药物处方的安全性和疗效日益受到关注。为此，认证机构和政策制定者制定了儿童精神药物最佳使用标准。此外，联邦立法促使各州实施监测计划，以解决弱势儿科亚群的质量和安全问题。在这里，我们报告了印第安纳州寄养青年计划的评估结果，该计划采用了离群值病例审查，然后由处方医生和儿童和青少年精神科医生之间进行同行咨询。我们观察到，与候补对照组相比，随机分配到即时干预组的青少年在药物种类、标签外用药、住院治疗、医疗费用和相关结果方面有显著的临床和统计学上的减少。
