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Evaluation of the Safer Use of Antipsychotics in Youth Study on Population Level Antipsychotic Initiation: An Interrupted Time Series Analysis.
West, Laura M; Mooney, Stephen J; Chavez, Laura; Beck, Arne; Clarke, Gregory N; Pabiniak, Chester J; Renz, Anne D; Penfold, Robert B.
Afiliação
  • West LM; Department of Epidemiology, University of Washington Seattle, Seattle, Washington, USA.
  • Mooney SJ; Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA.
  • Chavez L; Department of Epidemiology, University of Washington Seattle, Seattle, Washington, USA.
  • Beck A; Harborview Injury Prevention & Research Center, University of Washington, Seattle, Washington, USA.
  • Clarke GN; Center for Child Health Equity and Outcomes Research, The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA.
  • Pabiniak CJ; Kaiser Permanente Colorado, Institute for Health Research, Denver, Colorado, USA.
  • Renz AD; Kaiser Permanente Northwest Center for Health Research, Portland, Oregon, USA.
  • Penfold RB; Kaiser Permanente Washington Health Research Institute, Seattle, Washington, USA.
J Child Adolesc Psychopharmacol ; 34(7): 310-318, 2024 Sep.
Article em En | MEDLINE | ID: mdl-38743639
ABSTRACT

Background:

Antipsychotics carry a higher-risk profile than other psychotropic medications and may be prescribed for youth with conditions in which other first-line treatments are more appropriate. This study aimed to evaluate the population-level effect of the Safer Use of Antipsychotics in Youth (SUAY) trial, which aimed to reduce person-days of antipsychotic use among participants.

Methods:

We conducted an interrupted time series analysis using segmented regression to measure changes in prescribing trends of antipsychotic initiation rates pre-SUAY and post-SUAY trial at four U.S. health systems between 2013 and 2020.

Results:

In our overall model, adjusted for age and insurance type, antipsychotic initiation rates decreased by 0.73 (95% confidence interval [CI] 0.30, 1.16, p = 0.002) prescriptions per 10,000 person-months before the SUAY trial. In the first quarter following the start of the trial, there was an immediate decrease in the rate of antipsychotic initiations of 6.57 (95% CI 0.99, 12.15) prescriptions per 10,000 person-months. When comparing the posttrial period to the pretrial period, there was an increase of 1.09 (95% CI 0.32, 1.85) prescriptions per 10,000 person-months, but the increasing rate in the posttrial period alone was not statistically significant (0.36 prescriptions per 10,000 person-months, 95% CI -0.27, 0.99).

Conclusion:

The declining trend of antipsychotic initiation seen between 2013 and 2018 (pre-SUAY trial) may have naturally reached a level at which prescribing was clinically warranted and appropriate, resulting in a floor effect. The COVID-19 pandemic, which began in the final three quarters of the posttrial period, may also be related to increased antipsychotic medication initiation.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Antipsicóticos / Análise de Séries Temporais Interrompida Limite: Adolescent / Child / Female / Humans / Male País/Região como assunto: America do norte Idioma: En Revista: J Child Adolesc Psychopharmacol Assunto da revista: PEDIATRIA / PSICOFARMACOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Antipsicóticos / Análise de Séries Temporais Interrompida Limite: Adolescent / Child / Female / Humans / Male País/Região como assunto: America do norte Idioma: En Revista: J Child Adolesc Psychopharmacol Assunto da revista: PEDIATRIA / PSICOFARMACOLOGIA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos