Second-Generation Antipsychotic Utilization and Metabolic Parameter Monitoring in an Inpatient Pediatric Population:...

Area of Science:

• Pediatric Psychiatry
• Pharmacology
• Metabolic Health

Background:

• Second-generation antipsychotics (SGAs) are associated with significant adverse metabolic effects.
• Existing studies indicate deficiencies in monitoring these effects in pediatric outpatients.
• This study addresses the need for data on inpatient pediatric populations.

Purpose of the Study:

• To characterize the prescribing patterns of SGAs in pediatric inpatients.
• To assess the extent of metabolic parameter monitoring (MPM) in this population.
• To identify specific monitoring deficiencies for adverse effects.

Main Methods:

• Retrospective review of electronic medical records (EMRs) for 243 pediatric inpatients (<18 years) discharged on SGAs.
• Assessment of MPM using International Diabetes Federation (IDF) criteria for metabolic syndrome (waist circumference, fasting blood glucose, triglycerides, HDL, blood pressure).
• Analysis of SGA type, dosage, and frequency of utilization.

Main Results:

• Only 13.2% of patients had complete MPM for all parameters.
• Blood pressure was the most frequently monitored (99.2%), while waist circumference was the least (28%).
• Risperidone was the most prescribed SGA (41%), with an average daily dose of 1.92 mg.

Conclusions:

• Pediatric inpatients show higher rates of documented MPM for some parameters (e.g., glucose, lipids) compared to outpatients.
• Despite improvements, significant monitoring deficiencies remain for SGAs in this population.
• Further efforts are needed to ensure comprehensive metabolic monitoring for pediatric patients on SGAs.