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首页> 外文期刊>Journal of the American Academy of Child and Adolescent Psychiatry >Growth in the concurrent use of antipsychotics with other psychotropic medications in medicaid-enrolled children
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Growth in the concurrent use of antipsychotics with other psychotropic medications in medicaid-enrolled children

机译：纳入药物的儿童中同时使用抗精神病药和其他精神药物的人数增加

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Objective Second-generation antipsychotics (SGAs) have increasingly been prescribed to Medicaid-enrolled children; however, there is limited understanding of the frequency of concurrent SGA prescribing with other psychotropic medications. This study describes the epidemiology of concurrent SGA use with 4 psychotropic classes (stimulants, antidepressants, mood stabilizers, and α-agonists) among a national sample of Medicaid-enrolled children and adolescents 6 to 18 years old between 2004 and 2008. Method Repeated cross-sectional design was used, with national Medicaid Analytic eXtract data (10.6 million children annually). Logit and Poisson regression, standardized for year, demographics, and Medicaid eligibility group, estimated the probability and duration of concurrent SGA use with each medication class over time and examined concurrent SGAs in relation to clinical and demographic characteristics. Results While SGA use overall increased by 22%, 85% of such use occurred concurrently. By 2008, the probability of concurrent SGA use ranged from 0.22 for stimulant users to 0.52 for mood stabilizer users. Concurrent SGA use occurred for long durations (69%-89% of annual medication days). Although the highest users of concurrent SGA were participants in foster care and disability Medicaid programs or those with behavioral hospitalizations, the most significant increases over time occurred among participants who were income-eligible for Medicaid (+13%), without comorbid ADHD (+15%), were not hospitalized (+13%), and did not have comorbid intellectual disability (+45%). Conclusion Concurrent SGA use with other psychotropic classes increased over time, and the duration of concurrent therapy was consistently long term. Concurrent SGA regimens will require further research to determine efficacy and potential drug-drug interactions, given a practice trend toward more complex regimens in less-impaired children/adolescents.
机译：目的越来越多的第二代抗精神病药（SGAs）被纳入了接受医疗补助的儿童。然而，对同时使用SGA开具其他精神药物的频率了解甚少。这项研究描述了2004年至2008年间在美国国家医疗补助计划中招募的6至18岁儿童和青少年中4种精神病类别（兴奋剂，抗抑郁药，情绪稳定剂和α激动剂）同时使用SGA的流行病学。方法重复交叉使用全国医疗补助分析数据（每年1,060万儿童）进行分节设计。针对年份，人口统计学和医疗补助资格组进行标准化的Logit和Poisson回归，估计了随时间推移每种药物类别同时使用SGA的可能性和持续时间，并检查了与临床和人口统计学特征相关的并发SGA。结果虽然SGA的使用总体增加了22％，但其中的85％同时发生。到2008年，同时使用SGA的可能性从刺激性用户的0.22到情绪稳定器用户的0.52不等。同时使用SGA的时间很长（占全年用药天数的69％-89％）。尽管并发SGA的最高用户是寄养和残疾医疗补助计划的参与者或有行为住院的参与者，但随着时间的推移，最显着的增加发生在有收入资格的医疗补助（+ 13％），无合并症的多动症（+15）的参与者中％），未住院（+ 13％）和没有合并症的智力障碍（+ 45％）。结论随着时间的流逝，与其他精神科药物同时使用SGA的人数有所增加，并且并发治疗的持续时间长期稳定。考虑到在弱势儿童/青少年中趋向于更复杂的治疗方案的实践趋势，同时进行的SGA治疗方案将需要进一步的研究，以确定疗效和潜在的药物相互作用。

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