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Published Online: 30 August 2022

Racial and Ethnic Differences in Psychotropic Prescription Receipt Among Pediatric Patients Enrolled in North Carolina Medicaid

Alexis French, Ph.D. [email protected], Kelley A. Jones, Ph.D., Christopher Bush, M.P.H., Melissa A. Greiner, M.S., J. Nathan Copeland, M.D., M.P.H., Naomi O. Davis, Ph.D., Michelle S. Franklin, Ph.D., Nicole Heilbron, Ph.D., and Gary R. Maslow, M.D., M.P.H.Authors Info & Affiliations
Publication: Psychiatric Services
Volume 73, Number 12
https://doi.org/10.1176/appi.ps.202100473
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Abstract

Objective:

The authors aimed to examine racial-ethnic differences in filled psychotropic prescriptions among a pediatric Medicaid population.

Methods:

This retrospective cohort study included patients ages 0–21 with at least one North Carolina Medicaid claim from October 1, 2017, through September 30, 2018 (N=983,886). The primary outcome was a filled psychotropic prescription. Separate multivariable modified Poisson regression models generated adjusted risk ratios (ARRs) and 95% confidence intervals (CIs), adjusted for patient demographic characteristics.

Results:

Black and Hispanic patients were significantly less likely to receive any filled psychotropic prescription (ARR=0.61, 95% CI=0.60–0.62; ARR=0.29, 95% CI=0.28–0.29, respectively) compared with White and non-Hispanic patients. Furthermore, Black and Hispanic patients were less likely to receive filled prescriptions in the four included drug classes compared with White and non-Hispanic patients.

Conclusions:

Future studies should focus on understanding the factors contributing to racial and ethnic differences among pediatric patients receiving filled psychotropic prescriptions.

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Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Volume 73 • Number 12 • December 01, 2022
Pages: 1401 - 1404
PubMed: 36039550

History

Received: 9 August 2021
Revision received: 8 February 2022
Revision received: 28 March 2022
Accepted: 8 April 2022
Published online: 30 August 2022
Published in print: December 01, 2022

Keywords

  1. Child psychiatry/general
  2. Community psychiatry
  3. Primary care
  4. Research/service delivery

Authors

Details

Alexis French, Ph.D. [email protected]
Department of Psychiatry and Behavioral Sciences (French, Copeland, Davis, Heilbron, Maslow), Department of Population Health Sciences (Jones, Greiner), and Department of Pediatrics (Maslow), Duke University School of Medicine, Durham, North Carolina; Aetion, New York City (Bush); Duke-Margolis Center for Health Policy, Durham, North Carolina (Franklin); Carolina Institute for Developmental Disabilities, University of North Carolina School of Medicine, Chapel Hill (Franklin).
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Kelley A. Jones, Ph.D.
Department of Psychiatry and Behavioral Sciences (French, Copeland, Davis, Heilbron, Maslow), Department of Population Health Sciences (Jones, Greiner), and Department of Pediatrics (Maslow), Duke University School of Medicine, Durham, North Carolina; Aetion, New York City (Bush); Duke-Margolis Center for Health Policy, Durham, North Carolina (Franklin); Carolina Institute for Developmental Disabilities, University of North Carolina School of Medicine, Chapel Hill (Franklin).
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Christopher Bush, M.P.H.
Department of Psychiatry and Behavioral Sciences (French, Copeland, Davis, Heilbron, Maslow), Department of Population Health Sciences (Jones, Greiner), and Department of Pediatrics (Maslow), Duke University School of Medicine, Durham, North Carolina; Aetion, New York City (Bush); Duke-Margolis Center for Health Policy, Durham, North Carolina (Franklin); Carolina Institute for Developmental Disabilities, University of North Carolina School of Medicine, Chapel Hill (Franklin).
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Melissa A. Greiner, M.S.
Department of Psychiatry and Behavioral Sciences (French, Copeland, Davis, Heilbron, Maslow), Department of Population Health Sciences (Jones, Greiner), and Department of Pediatrics (Maslow), Duke University School of Medicine, Durham, North Carolina; Aetion, New York City (Bush); Duke-Margolis Center for Health Policy, Durham, North Carolina (Franklin); Carolina Institute for Developmental Disabilities, University of North Carolina School of Medicine, Chapel Hill (Franklin).
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J. Nathan Copeland, M.D., M.P.H.
Department of Psychiatry and Behavioral Sciences (French, Copeland, Davis, Heilbron, Maslow), Department of Population Health Sciences (Jones, Greiner), and Department of Pediatrics (Maslow), Duke University School of Medicine, Durham, North Carolina; Aetion, New York City (Bush); Duke-Margolis Center for Health Policy, Durham, North Carolina (Franklin); Carolina Institute for Developmental Disabilities, University of North Carolina School of Medicine, Chapel Hill (Franklin).
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Naomi O. Davis, Ph.D.
Department of Psychiatry and Behavioral Sciences (French, Copeland, Davis, Heilbron, Maslow), Department of Population Health Sciences (Jones, Greiner), and Department of Pediatrics (Maslow), Duke University School of Medicine, Durham, North Carolina; Aetion, New York City (Bush); Duke-Margolis Center for Health Policy, Durham, North Carolina (Franklin); Carolina Institute for Developmental Disabilities, University of North Carolina School of Medicine, Chapel Hill (Franklin).
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Michelle S. Franklin, Ph.D.
Department of Psychiatry and Behavioral Sciences (French, Copeland, Davis, Heilbron, Maslow), Department of Population Health Sciences (Jones, Greiner), and Department of Pediatrics (Maslow), Duke University School of Medicine, Durham, North Carolina; Aetion, New York City (Bush); Duke-Margolis Center for Health Policy, Durham, North Carolina (Franklin); Carolina Institute for Developmental Disabilities, University of North Carolina School of Medicine, Chapel Hill (Franklin).
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Nicole Heilbron, Ph.D.
Department of Psychiatry and Behavioral Sciences (French, Copeland, Davis, Heilbron, Maslow), Department of Population Health Sciences (Jones, Greiner), and Department of Pediatrics (Maslow), Duke University School of Medicine, Durham, North Carolina; Aetion, New York City (Bush); Duke-Margolis Center for Health Policy, Durham, North Carolina (Franklin); Carolina Institute for Developmental Disabilities, University of North Carolina School of Medicine, Chapel Hill (Franklin).
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Gary R. Maslow, M.D., M.P.H.
Department of Psychiatry and Behavioral Sciences (French, Copeland, Davis, Heilbron, Maslow), Department of Population Health Sciences (Jones, Greiner), and Department of Pediatrics (Maslow), Duke University School of Medicine, Durham, North Carolina; Aetion, New York City (Bush); Duke-Margolis Center for Health Policy, Durham, North Carolina (Franklin); Carolina Institute for Developmental Disabilities, University of North Carolina School of Medicine, Chapel Hill (Franklin).
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Notes

Send correspondence to Dr. French ([email protected]).

Competing Interests

Dr. Davis has received research support from Akili Interactive Labs. Dr. Maslow has received research funding from Pfizer and the National Institutes of Health; program funding from the U.S. Department of Health and Human Services (DHHS), HRSA, and The Arc of North Carolina; and program support from the North Carolina DHHS. The other authors report no financial relationships with commercial interests.

Funding Information

This study was supported by Health Resources and Services Administration (HRSA) grant U4C-MC-32315. These views represent the opinions of the authors and not necessarily those of HRSA; HRSA had no role in the design and conduct of this study.

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