and 20.7%, respectively). Of those treated with antipsychotics, only 8.7% received glucose and lipids screening. Most children diagnosed with ADHD are prescribed the recommended first-line stimulants; however, follow-up after initiation of medication is poor. 85% of children diagnosed with ADHD were prescribed an amphetamine or methylphenidate-based stimulant. Only about a third of youth (32.9%) had at least one follow-up visit with a prescribing practitioner within 30 days of initiating the stimulant. Quality of care for Preschoolers Most young children treated with psychotropic medications do not receive psychosocial treatment. The prevalence of antipsychotic use among children aged 2-5 was .78%. Of those young children prescribed antipsychotics, most (70.9%) were diagnosed with behavioral disorders. Of those young children prescribed psychotropic medications, only about one fifth (20.5%) had 6 or more psychosocial visits prior to initiating the medication and 54.6% had 6 or more psychosocial visits after initiating the medication. Continuity of Care Most children with mental health problems admitted to the emergency room and/or hospital do not receive timely outpatient follow-up. Of the children admitted to the emergency room, only 38% (4 out of 10 children) received an outpatient follow-up within 30 days. Less than two-thirds (62.2%) receiving an outpatient visits after hospital discharge Policy Implications The findings provide important guidance for policy and practice to improve the quality of care for children and adolescents. Three main implications emerge from this study: Need for quality improvement efforts focused on inappropriate prescribing The results from the study suggest that questionable psychotropic prescribing is common including the use of concomitant medications, doses that exceed the recommended maximum, and prescribing to children under age six. Such practices not only pose health risks but the effectiveness is virtually unknown. Quality improvement initiatives are needed to improve psychotropic prescribing practices, especially for children in foster care.
and 20.7%, respectively). Of those treated with antipsychotics, only 8.7% received glucose and lipids screening. Most children diagnosed with ADHD are prescribed the recommended first-line stimulants; however, follow-up after initiation of medication is poor. 85% of children diagnosed with ADHD were prescribed an amphetamine or methylphenidate-based stimulant. Only about a third of youth (32.9%) had at least one follow-up visit with a prescribing practitioner within 30 days of initiating the stimulant. Quality of care for Preschoolers Most young children treated with psychotropic medications do not receive psychosocial treatment. The prevalence of antipsychotic use among children aged 2-5 was .78%. Of those young children prescribed antipsychotics, most (70.9%) were diagnosed with behavioral disorders. Of those young children prescribed psychotropic medications, only about one fifth (20.5%) had 6 or more psychosocial visits prior to initiating the medication and 54.6% had 6 or more psychosocial visits after initiating the medication. Continuity of Care Most children with mental health problems admitted to the emergency room and/or hospital do not receive timely outpatient follow-up. Of the children admitted to the emergency room, only 38% (4 out of 10 children) received an outpatient follow-up within 30 days. Less than two-thirds (62.2%) receiving an outpatient visits after hospital discharge Policy Implications The findings provide important guidance for policy and practice to improve the quality of care for children and adolescents. Three main implications emerge from this study: Need for quality improvement efforts focused on inappropriate prescribing The results from the study suggest that questionable psychotropic prescribing is common including the use of concomitant medications, doses that exceed the recommended maximum, and prescribing to children under age six. Such practices not only pose health risks but the effectiveness is virtually unknown. Quality improvement initiatives are needed to improve psychotropic prescribing practices, especially for children in foster care.
QualityMeasures.docx