Predictors of Polypharmacy and Off-Label Prescribing of Psychotropic Medications: A National Survey of Child and Adolescent Psychiatrists

被引:18
|
作者
Kearns, Marcia A. [1 ]
Hawley, Kristin M. [1 ]
机构
[1] Univ Missouri, Dept Psychol Sci, Columbia, MO 65211 USA
关键词
prescribing practices; polypharmacy; off-label prescribing; pediatric psychopharmacology; comorbidity; SEROTONIN REUPTAKE INHIBITORS; ATTENTION-DEFICIT/HYPERACTIVITY; ANTIPSYCHOTIC MEDICATIONS; ANTIEPILEPTIC DRUGS; OUTPATIENT CHILD; MENTAL-DISORDERS; PREVALENCE; PATTERNS; PHARMACOTHERAPY; ATTITUDES;
D O I
10.1097/01.pra.0000456592.20622.45
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
We employed a national survey of child psychiatrists to examine typical prescribing practices for children with anxiety, depression, and disruptive behavior disorders. We examined the extent to which polypharmacy and off-label prescribing occur in routine practice and the degree to which child characteristics, child psychiatrist characteristics, and medication availability may influence these prescribing practices. We found that child psychiatrists most often prescribed medications that were on-label according to U.S. Food and Drug Administration (FDA) guidelines, and that they were progressively less likely to choose medications with partial approval (i.e., medications having pediatric approval but not for the patient's age or problem type), and then medications with no pediatric approval. We also found that prescribing multiple concomitant medications was the norm. We employed best subsets regression to determine the best theoretically relevant predictors to explain polypharmacy and off-label prescribing and found that the best fitting model only included number of child diagnoses. These findings suggest that comorbidity is an important issue in the pharmacotherapy of children with mental health disorders and one that must be addressed in future clinical trials.
引用
收藏
页码:438 / 447
页数:10
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