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Providers' Behaviors and Beliefs on Prescribing Antipsychotic Medication to Children: A Qualitative Study
W David Lohr1, Kyle B Brothers1, Deborah Winders Davis1
1Child and Adolescent Research Design and Support (CAHRDS) Unit, Department of Pediatrics, University of Louisville School of Medicine, Louisville, KY, 40202, USA.
Insights
Fragmented child mental health care leads to high antipsychotic medication (APM) use. Interventions are needed to improve prescribing practices and safeguard APM use in pediatric behavioral health, addressing access barriers and social influences.
Area of Science:
- Child and Adolescent Psychiatry
- Behavioral Health Services Research
- Health Policy and Management
Background:
- Fragmented care in child behavioral and mental health services contributes to suboptimal treatment outcomes.
- High rates of psychotropic medication, particularly antipsychotic medications (APM), are prevalent in pediatric populations.
- Understanding prescribing patterns is crucial for improving care quality and safety.
Purpose of the Study:
- To explore prescribing practices for APM in children within Kentucky.
- To identify barriers to optimal treatment and safeguarding APM use.
- To propose interventions based on the Theory of Planned Behavior (TPB).
Main Methods:
- A qualitative study design was employed.
- The Theory of Planned Behavior (TPB) provided the theoretical framework.
- Data collection focused on understanding prescribing practices and barriers.
Main Results:
- Limited access to mental health specialists emerged as the primary barrier to optimal care.
- Social norms and family pressures were identified as contributing factors to increased medication use.
- The study identified potential interventions grounded in TPB principles.
Conclusions:
- Addressing specialist access is critical for improving pediatric mental health care.
- Interventions should consider social and familial influences on prescribing.
- The TPB offers a valuable framework for developing strategies to safeguard APM use in children.
Abstract:
Fragmentation in behavioral and mental health care to children has resulted in suboptimal care and high rates of psychotropic medication use, especially antipsychotic medications (APM). A qualitative study, based on the Theory of Planned Behavior (TPB), aimed to better understand prescribing practices, barriers to optimal treatment, and potential interventions to safeguard the use of APM for children in Kentucky. The most common barrier to optimal care was access to mental health specialists. Social norms and pressure from families contribute to increased medication use. We identify promising interventions to safeguard the use of APM through the lens of the TPB.