Monitoring of Patients on Second-Generation Antipsychotics: A National Survey of Child Psychiatrists

Objective:

The survey assessed self-reported monitoring by child psychiatrists of children prescribed second-generation antipsychotics, facilitators and barriers to monitoring, and steps taken to adhere to monitoring.

Methods:

The authors anonymously surveyed 4,144 U.S. child psychiatrists. Descriptive statistics and multiple linear regressions were utilized to describe results and identify correlates of monitoring.

Results:

Among responders (N=1,314, 32%), over 95% were aware of all guidelines, over 80% agreed with most guidelines, but less than 20% had adopted and adhered to most guidelines. Awareness of guidelines, working within an academic practice, and fewer years in practice predicted adherence.

Conclusions:

Child psychiatrists have generally not adopted the guidelines for monitoring children on second-generation antipsychotics. Interventions to improve monitoring should target child psychiatrists in nonacademic practices and those who have been out of training for longer periods. Future research should assess family barriers to monitoring.