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Eye Tracking Young Children with Autism
Published on: March 27, 2012
Age-Related Patterns and Longitudinal Trends in Psychotropic Medication Use Among Commercially Insured Children with
Cindy M Chan1, Kylie M Stitt2, Samuel K Peasah1,3
1School of Pharmacy, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Insights
Psychotropic medication use in children with autism spectrum disorder (ASD) varies by age, with older children more frequently receiving multiple medications. Complex treatment regimens in ASD are linked to a higher burden of co-occurring conditions.
Area of Science:
- Pediatric Psychiatry
- Neurodevelopmental Disorders
- Pharmacology
Background:
- Autism spectrum disorder (ASD) often co-occurs with other psychiatric and behavioral conditions.
- Psychotropic medication is frequently used to manage symptoms in children with ASD.
- Understanding medication use patterns and treatment complexity is crucial for optimizing care.
Purpose of the Study:
- To analyze temporal trends in psychotropic medication use among children with ASD.
- To examine how medication use differs across pediatric age groups.
- To characterize the comorbidity profile of children with ASD on complex treatment regimens.
Main Methods:
- Retrospective cohort study using administrative claims data (N=2747).
- Analysis of psychotropic medication use in children aged 0-17 years with ASD over 3 years.
- Stratification by age groups (0-4, 5-9, 10-17 years) and definition of high treatment complexity (polypharmacy and/or antipsychotic use).
Main Results:
- Psychotropic medication use and polypharmacy increased with age in children with ASD.
- Medication use rose in younger children but fell in adolescents over the 3-year period.
- High treatment complexity (20.5% of children) was associated with increased prevalence of comorbidities like ADHD, mental health disorders, and behavioral issues.
Conclusions:
- Age-dependent variations exist in psychotropic medication patterns for children with ASD.
- Increased treatment complexity in ASD is correlated with a greater burden of co-occurring psychiatric and behavioral conditions.
- Longitudinal studies are needed to explore treatment trajectories, symptom changes, and social impacts in pediatric ASD pharmacotherapy.
Objectives:
This study aimed to describe changes in psychotropic medication use over time in commercially insured children with autism spectrum disorder (ASD) across age groups and characterize the comorbidity burden in patients with more complex treatment regimens.
Methods:
Using deidentified administrative claims from the Workpartners Research Reference Database, we conducted a retrospective cohort study of employee dependents aged 0-17 years with ASD followed for 3 years. Psychotropic medication use was analyzed across three age groups (0-4, 5-9, and 10-17 years). In a subgroup with high treatment complexity, defined as polypharmacy (≥3 drug classes) and/or antipsychotic use, the prevalence of various co-occurring conditions associated with ASD was also described.
Results:
Among 2747 children with ASD, psychotropic medication use and polypharmacy were more common in older age groups. At Year 1, 32.8% of children aged 10-17 used ≥2 drug classes concurrently, compared with 0.9% and 15.3% in the 0-4 and 5-9 age groups, respectively. From Year 1 to Year 3, medication use increased in younger children but declined in the 10-17 age group. High treatment complexity was observed in 20.5% of children (n = 562) over the entire 3-year study period, most frequently in the 10-17 age group. A higher prevalence of comorbidities, including attention-deficit hyperactivity disorder, mental health conditions, conduct disorders, and irritability and agitation, was observed in those with high treatment complexity compared with those without.
Conclusions:
Pharmacologic treatment patterns varied by age in children with ASD, and higher treatment complexity was associated with more frequent diagnoses of co-occurring psychiatric and behavioral conditions. Further understanding of longitudinal treatment trajectories should be explored in future research, such as by contextualizing treatment changes with symptom assessment and evaluating the social impact of treatment complexity.
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