Multiple psychotropic medication use for youths: A two-state comparison
Multiple psychotropic medication use for youths: A two-state comparison
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DOI：
10.1089/cap.2005.15.68
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发表时间：
2005-02-01
影响因子：
1.9
通讯作者：
Owens, PL
中科院分区：
文献类型：
--
作者：
dosReis, S;Zito, JM;Owens, PL
目的：本研究的目的是比较美国大西洋中部的两个州医疗补助计划和州儿童健康保险计划(SCIP)的青少年的多种精神药物使用情况。方法：利用管理数据分析1999年在两个州连续参加医疗补助计划或SCIP计划的20岁以下青少年的多次精神药物使用情况。多次精神药物使用指的是多类别组合，并由多次使用的月数来定义。主要观察指标为多次使用精神药物的流行率和多次使用的月数。结果：在连续招募的青少年中，21%-22%的人至少有一次与精神健康相关的就诊，8%-10%的人接受过精神药物治疗，2%-3%的人接受过多种精神药物治疗。近三分之一(28%-30%)的有任何精神药物使用的年轻人接受了多种药物治疗，其中近一半的药物使用时间为5-12个月。多类药物的使用在男性、白人、10-14岁、残疾人和寄养青少年中更为常见。兴奋剂与抗抑郁药、抗精神病药物或α-激动剂是最常见的组合。结论：在接受任何精神药物治疗的年轻人中，近三分之一发生了多次使用。还需要更多的研究来调查转换模式和联合药物治疗的有效性。
Objective: The aim of this study was to compare multiple psychotropic use among youths enrolled in two U.S. mid-Atlantic state Medicaid and state Children's Health Insurance Programs (SCHIP).Methods: Administrative data were used to examine multiple psychotropic use among youths less than 20 years of age and who were continuously enrolled in Medicaid or SCHIP programs in two states during 1999. Multiple psychotropic use referred to multiclass combinations and was defined by the number of months of multiple use. Main outcome measures were the prevalence of multiple psychotropic use and months of multiple use. Demographic and clinical characteristics, mental health visits, and common combinations were examined according to months of multiple use.Results: Among continuously enrolled youths, 21%-22% had at least one mental health-related visit, 8%-10% received a psychotropic medication, and 2%-3% received multiple psychotropic medications. Nearly one third (28%-30%) of youths with any psychotropic use received multiple medications, of which almost half was for 5-12 months. Multiclass use was more common in male, white, aged 10-14, disabled, and foster-care youths. Stimulants with antidepressants, antipsychotics, or alpha-agonists were the most common combinations.Conclusions: Multiple use occurred in nearly one third of youths with any psychotropic treatment. Additional research is needed to investigate switching patterns and the effectiveness of combined pharmacotherapy.