A Second-Opinion Program for the Care of Youths Prescribed Five or More Psychotropics in Washington State.

Rebecca P Barclay, Erin Dillon-Naftolin, Douglas Russell, Robert J Hilt

Psychiatric services (Washington, D.C.) 2021 Mar 01

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This retrospective study describes a second-opinion review program for the care of children in Washington State who received Medicaid coverage and who were prescribed five or more psychotropic medications, primarily by mental health specialists. In total, 136 second-opinion reviews from 2013 and 169 from 2018 were included in this study. Attention-deficit hyperactivity disorder (ADHD), behavioral difficulties, anxiety, and trauma were prevalent among these children, and participants were commonly prescribed ADHD medications, selective serotonin reuptake inhibitors, and second-generation antipsychotics. The incidence of reviews remained stable over the two periods, but psychosocial treatment increased significantly over this time. This study sheds light on the initiation, maintenance, and identification of polypharmacy psychotropic regimens and highlights psychosocial treatment as an intervention that increases best practice care for at-risk patients.

Citation

Rebecca P Barclay, Erin Dillon-Naftolin, Douglas Russell, Robert J Hilt. A Second-Opinion Program for the Care of Youths Prescribed Five or More Psychotropics in Washington State. Psychiatric services (Washington, D.C.). 2021 Mar 01;72(3):362-365