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Psychotropic Medication Patterns for American Indian Children in Foster Care
David Glesener1, Gwendolyn Anderson2, Xuan Li3
11 Department of Social Work, University of Minnesota , St. Paul, Minnesota.
Insights
Psychotropic medication use in foster care children varied by race and sex. American Indian children were prescribed fewer medications, while European American children, males, and older children received more diverse prescriptions.
Area of Science:
- Child and Adolescent Psychiatry
- Health Services Research
- Pharmacology
Background:
- Psychotropic medication use is common among children in foster care.
- Understanding disparities in psychotropic medication use is crucial for equitable care.
- Factors such as race, age, sex, and duration in foster care may influence prescribing patterns.
Purpose of the Study:
- To assess the impact of race, age, sex, and time in foster care on psychotropic medication use in 2012.
- To identify potential disparities in the prescription of different psychotropic medication classes.
Main Methods:
- Retrospective analysis of electronic health records for 626 children in foster care in St. Louis County, Minnesota, in 2012.
- Categorization of psychotropic medications into antidepressants, ADHD medications, antipsychotics, alpha-agonists, and others.
- Statistical analysis to determine the association between demographic factors and medication dispensing rates.
Main Results:
- Overall, 26% of children received at least one psychotropic medication.
- American Indian (AI) children were less likely to receive any psychotropic or ADHD medication compared to European American (EA) and African American (AA) children.
- Males, older children, and those with longer foster care durations were prescribed a wider range and higher rates of psychotropic medications.
Conclusions:
- Significant racial disparities exist in psychotropic medication dispensing for foster care children, with AI children receiving less medication.
- Further research is needed to ensure equitable mental health care access and appropriate treatment for all children in foster care.
- Investigating the underlying reasons for these disparities, considering patient needs and preferences, is essential.
Objective:
This study assesses the effects of race, age, sex, and time spent in foster care on rates of psychotropic medication use for children in foster care in 2012.
Methods:
Using existing electronic records through county Social Service and Minnesota Medical Assistance databases, 626 children were identified using the inclusion criteria of having been in foster care for at least 30 days during 2012 in St. Louis County, Minnesota. All prescriptions for dispensed psychotropic medications were identified into the following classes: antidepressants, attention-deficit/hyperactivity disorder (ADHD) medications, antipsychotics, alpha-agonists, and other (including anticonvulsants/mood stabilizers, lithium, benzodiazepines, and sedative hypnotics).
Results:
Overall, 26% of children were dispensed at least one psychotropic medication during the year with the percentage of children on medication for each race as follows: American Indian (AI) 23.3%, European American (EA) 29.2%, and African American (AA) 18.3%. AI children were significantly less likely to be dispensed any psychotropic medication and ADHD medication. EA children, males, and older children received psychotropic medications from significantly more classes than AI or AA children, females, and younger children. Males were significantly more likely to be dispensed alpha-agonists, antipsychotics, and ADHD medications. Increased time since placement into foster care was also significantly associated with increased dispensing rates of antidepressants, ADHD medication, and multiple medication classes.
Conclusions:
The results of this study show that non-EA children, in particular AI children, were dispensed psychotropics both overall and across different medication classes less often compared to other racial groups. While the reasons for this difference are not known, future studies are needed to address whether mental health needs of all children in foster care are being appropriately addressed, accounting for need and patient preference.
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