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Articles   |    
Age-Related Trends in Psychotropic Medication Use Among Very Young Children in Foster Care
Susan dosReis, Ph.D.; Ming-Hui Tai, M.S., M.H.P.A.; David Goffman, Pharm.D.; Sean E. Lynch, Ph.D., M.S.W.; Gloria Reeves, M.D.; Terry Shaw, Ph.D.
Psychiatric Services 2014; doi: 10.1176/appi.ps.201300353
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Dr. dosReis, Ms. Tai, and Dr. Goffman are with the Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore (e-mail: sdosreis@rx.umaryland.edu). Dr. Lynch is with the Department of Psychiatry, University of Florida College of Medicine, Jacksonville. Dr. Reeves is with the Division of Child and Adolescent Psychiatry, Department of Psychiatry, University of Maryland School of Medicine, Baltimore. Dr. Shaw is with the School of Social Work, University of Maryland, Baltimore.

Copyright © 2014 by the American Psychiatric Association

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Abstract

Objectives  The specific objectives were to investigate changes in the prevalence of psychotropic medication use for each year increase in age from three to six years old among children in foster care and to examine time-varying odds of longer duration of use by each year of age.

Methods  A retrospective analysis of data on mental health and pharmacy services was conducted for 1,491 children age six and younger who were in foster care in 2010 and had at least 365 days in foster care during 2009–2011. A total of 178 children received at least one psychotropic medication from 2009 through 2011. Psychotropic prevalence and average days of use were calculated for each therapeutic class. Longitudinal regression models assessed the time-varying relationship between year of age and duration of use, controlling for demographic and clinical covariates.

Results  Approximately 12% of children age six and younger in foster care for 365 days or more received at least one psychotropic medication over the three-year study period. Prevalence of ADHD medication and antipsychotic medication and duration increased with each year of age (p<.001). In adjusted longitudinal models, each year increase in age was associated with a nearly twofold higher likelihood of longer duration of antipsychotic and ADHD medication use.

Conclusions  Young children who initiated antipsychotic and ADHD medications before the age of six continued to receive them for longer periods of time. There is a critical need for long-term studies to evaluate the effect of chronic exposure on children’s health and well-being.

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