Psychotropic Polypharmacy Combinations and Duration of Polypharmacy Among Medicaid-Enrolled Youths.

IF 3.3 3区医学 Q1 HEALTH POLICY & SERVICES

Psychiatric services Pub Date : 2024-08-14 DOI:10.1176/appi.ps.20240113

Yueh-Yi Chiang, Alejandro Amill-Rosario, Phuong Tran, Susan dosReis

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Abstract

Objective: This study evaluated psychotropic polypharmacy frequency and patterns of use among Medicaid-enrolled youths.

Methods: A cross-sectional study of a state Medicaid claims database (2015-2020) focused on youths (≤17 years old) with at least one psychotropic medication claim and ≥90 continuous days of Medicaid enrollment. Psychotropic polypharmacy (claims for three or more therapeutic classes of psychotropics for ≥90 consecutive days) was analyzed as average annual days and annual prevalence of class combinations. Multivariable negative binomial regression models assessed changes in annual psychotropic polypharmacy days.

Results: A total of 126,972 unique youths were identified. Almost all youths with psychotropic polypharmacy had three-class combinations, the most common of which included attention-deficit hyperactivity disorder medications, antipsychotics, and antidepressants. The number of polypharmacy days increased from a mean±SD of 227.8±90.3 in 2015 to 235.7±97.5 in 2020. Polypharmacy days significantly increased year over year (rate ratio=1.01, 95% CI=1.00-1.01).

Conclusions: Psychotropic polypharmacy regimens reflect chronic use that is increasing over time.

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医疗补助计划（Medicaid）参保青少年的精神药物复方组合和复方用药持续时间。

目的：本研究评估了参加医疗补助计划的青少年使用精神药物的频率和模式：本研究评估了参加医疗补助计划的青少年使用精神药物的频率和模式：对州医疗补助报销数据库（2015-2020 年）进行横断面研究，重点关注至少有一项精神药物报销且连续参加医疗补助≥90 天的青少年（≤17 岁）。精神药物多药（连续≥90 天报销三种或三种以上治疗类别的精神药物）按年均天数和类别组合的年流行率进行分析。多变量负二项回归模型评估了每年精神药物多药使用天数的变化：结果：共识别出 126,972 名青少年。几乎所有滥用精神药物的青少年都有三类药物组合，其中最常见的包括注意力缺陷多动障碍药物、抗精神病药物和抗抑郁药物。使用多种药物的天数从 2015 年的平均值（±SD）227.8±90.3 天增加到 2020 年的 235.7±97.5 天。多药治疗天数逐年明显增加（比率=1.01，95% CI=1.00-1.01）：结论：精神药物多药治疗方案反映了随着时间推移而不断增加的慢性使用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Psychiatric services 医学-公共卫生、环境卫生与职业卫生

CiteScore

5.80

自引率

7.90%

发文量

295

审稿时长

3-8 weeks

期刊介绍： Psychiatric Services, established in 1950, is published monthly by the American Psychiatric Association. The peer-reviewed journal features research reports on issues related to the delivery of mental health services, especially for people with serious mental illness in community-based treatment programs. Long known as an interdisciplinary journal, Psychiatric Services recognizes that provision of high-quality care involves collaboration among a variety of professionals, frequently working as a team. Authors of research reports published in the journal include psychiatrists, psychologists, pharmacists, nurses, social workers, drug and alcohol treatment counselors, economists, policy analysts, and professionals in related systems such as criminal justice and welfare systems. In the mental health field, the current focus on patient-centered, recovery-oriented care and on dissemination of evidence-based practices is transforming service delivery systems at all levels. Research published in Psychiatric Services contributes to this transformation.

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