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Who is prescribing psychotropic medications in a public developmental-behavioural clinical service and how often?

Katherine L Hughes1, Gehan Roberts1,2,3

  • 1Centre for Community Child Health, Royal Children's Hospital, Melbourne, Victoria, Australia.

Journal of Paediatrics and Child Health
|November 14, 2019
PubMed

Insights

Psychotropic prescribing by paediatricians was 16.7% in developmental-behavioural clinics. Consultants prescribed more often than advanced trainees, indicating a need for more training.

Area of Science:

  • Pediatric medicine
  • Psychopharmacology
  • Clinical practice

Background:

  • Psychotropic medication use in pediatrics is rising.
  • Significant variability exists in prescribing practices.
  • Developmental-behavioural clinics manage complex pediatric cases.

Purpose of the Study:

  • To determine psychotropic prescribing rates in pediatric developmental-behavioural clinics.
  • To compare prescribing patterns between pediatric consultants and advanced trainees.
  • To identify potential areas for improved training and care standardization.

Main Methods:

  • Retrospective analysis of 5069 appointment encounters over 12 months in 2017.
  • Data extracted from electronic medical records, including patient demographics, provider, and medication orders.
  • Statistical analysis using Excel and STATA for logistic regression, standard deviation, percentages, and means.

Main Results:

  • 16.7% of encounters involved psychotropic prescribing (847/5069).
  • Consultants prescribed psychotropic medications in 23% of encounters versus 4.4% for advanced trainees (P < 0.001).
  • Stimulants were the most frequent psychotropic class (62%), used alone (86.3%) or in combination (13.7%).

Conclusions:

  • Observed psychotropic prescribing rates were lower than anticipated.
  • Advanced trainees demonstrated significantly lower prescribing rates compared to consultants.
  • Findings suggest a potential need for enhanced psychotropic prescribing experience and training for advanced trainees.
Abstract

Keywords:
clinical competencepaediatricianphysicianpractice patternpsychotropic drug

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