Greta Bushnell (
James Lloyd, Rutgers University.
Health Aff (Millwood). 2023 Jul;42(7):973-980. doi: 10.1377/hlthaff.2022.01625.
After the rapid growth of pediatric antipsychotic prescribing in the early 2000s, especially in the Medicaid population, concerns regarding the safety and appropriateness of such prescribing increased. Many states implemented policy and educational initiatives aimed at safer and more judicious antipsychotic use. Antipsychotic use leveled off in the late 2000s, but there have been no recent national estimates of trends in antipsychotic use in children enrolled in Medicaid, and it is unclear how use varied by race and ethnicity. This study observed a sizable decline in antipsychotic use among children ages 2-17 between 2008 and 2016. Although the magnitude of change varied, declines were observed across foster care status, age, sex, and racial and ethnic groups studied. The proportion of children with an antipsychotic prescription who received any diagnosis associated with a pediatric indication that was approved by the Food and Drug Administration increased from 38 percent in 2008 to 45 percent in 2016, which may indicate a trend toward more judicious prescribing.
在 21 世纪初,儿科抗精神病药物的处方量迅速增长,尤其是在医疗补助人群中,这引起了人们对这种处方的安全性和适当性的担忧。许多州都采取了政策和教育措施,旨在更安全、更明智地使用抗精神病药物。抗精神病药物的使用在 21 世纪后期趋于平稳,但目前尚无关于参加医疗补助计划的儿童中抗精神病药物使用趋势的最新全国估计数,也不清楚使用情况是否因种族和民族而异。本研究观察到,2008 年至 2016 年间,2-17 岁儿童的抗精神病药物使用量大幅下降。尽管变化幅度有所不同,但在接受研究的寄养状况、年龄、性别以及种族和族裔群体中,均观察到下降趋势。有抗精神病药物处方的儿童中,接受食品和药物管理局批准的任何与儿科适应证相关的诊断的比例从 2008 年的 38%上升到 2016 年的 45%,这可能表明处方更趋于合理。