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Adherence to Guidelines and Federal Psychotropic Medication Labels for the Treatment of Medicaid-Insured Children
Daniel Kim1, Steven P Cuffe1, Pinar Keskinocak1
1H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta (Kim, Keskinocak, Serban); Department of Psychiatry, University of Florida College of Medicine-Jacksonville, Jacksonville (Cuffe); Department of Psychiatry, University of Illinois Chicago College of Medicine, Chicago (Naylor).
Objective:
This study examined adherence to clinical practice guidelines (CPGs) and U.S. Food and Drug Administration (FDA) medication labels when prescribing psychotropic medications to Medicaid-insured children with attention-deficit hyperactivity disorder (ADHD).
Methods:
A retrospective analysis was conducted with 2016-2018 Medicaid claims data across 46 states for children with an ADHD diagnosis and at least one psychotropic medication prescription (N=1,236,068 children). Medications recommended for pediatric use were identified with CPGs from the American Academy of Child and Adolescent Psychiatry and the Florida Medicaid Drug Therapy Management Program for Behavioral Health.
Results:
Across 46 states, 86.7% of children received guideline-recommended and FDA-approved medications for the treatment of ADHD and comorbid mental disorders. Antidepressants, antihistamines, and second-generation antipsychotics that were not included in CPGs were prescribed for 23.4% of children.
Conclusions:
High adherence to CPGs and FDA medication labels for medications prescribed for ADHD was observed, suggesting the effectiveness of guidelines in driving evidence-based care.
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