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Use of Multiple Concurrent Antipsychotics in Children and Adolescents

This HEDIS Measure

Assesses the percentage of children and adolescents who were on two or more concurrent antipsychotic medications for an extended period of time during the year.

So What?

Antipsychotic prescribing in children and adolescents has increased rapidly in recent decades.1,2 Among those prescribed an antipsychotic, about 1 in 10 are prescribed more than one antipsychotic at the same time.3 Children and adolescents prescribed antipsychotics are at risk for serious health concerns, including weight gain, extrapyramidal side effects, hyperprolactinemia and some metabolic effects.4

Because risks of multiple concurrent antipsychotic use in children and adolescents has not been systematically investigated, guidelines caution against their use, due to the lack of evidence supporting use and the risks these medications pose.5 This measure can highlight potentially unsafe use of antipsychotic medications.

References

  1. Patten, S.B., W. Waheed, L. Bresee. 2012. “A review of pharmacoepidemiologic studies of antipsychotic use in children and adolescents.” Canadian Journal of Psychiatry 57:717–21.
  2. Cooper, W.O., P.G. Arbogast, H. Ding, G.B. Hickson, D.C. Fuchs, and W.A. Ray. 2006. “Trends in prescribing of antipsychotic medications for US children.” Ambulatory Pediatrics 6(2):79–83.
  3. Toteja, N., J.A. Gallego, E. Saito, T. Gerhard, A. Winterstein, M. Olfson, C.U. Correll. 2013. “Prevalence and correlates of antipsychotic polypharmacy in children and adolescents receiving antipsychotic treatment.” International Journal of Neuropsychopharmacology 17(7):1095–105.
  4. Correll, C.U., C.J. Kratochvil, J.S. March. 2011. “Developments in pediatric psychopharmacology: Focus on stimulants, antidepressants, and antipsychotics.” Journal of Clinical Psychiatry 72:655–70.
  5. American Academy of Child and Adolescent Psychiatry. September 2009. “Practice parameter on the use of psychotropic medication in children and adolescents.” Journal of the American Academy of Child and Adolescent Psychiatry 48(9):961–73.
tables
Use of Concurrent Antipsychotics in Children and Adolescents
  Commercial Medicaid Medicare
Year HMO PPO HMO HMO PPO
2016 2.5 2.7 2.4 _ _
2015

2.4

2.9

2.5

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*Lower rates signify better performance


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