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Published Online: 19 June 2024

Adherence to Guidelines and Federal Psychotropic Medication Labels for the Treatment of Medicaid-Insured Children With ADHD

Daniel Kim, M.S., Steven P. Cuffe, M.D., Pinar Keskinocak, Ph.D., Michael W. Naylor, M.D., and Nicoleta Serban, Ph.D. [email protected]Authors Info & Affiliations
Publication: Psychiatric Services
Volume 75, Number 11
https://doi.org/10.1176/appi.ps.20230369
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Abstract

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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Information & Authors

Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services
Psychiatric Services
Volume 75 • Number 11 • November 01, 2024
Pages: 1151 - 1156

History

Received: 23 July 2023
Revision received: 13 November 2023
Revision received: 10 February 2024
Revision received: 18 April 2024
Accepted: 25 April 2024
Published online: 19 June 2024
Published in print: November 01, 2024

Keywords

  1. adherence
  2. adolescents/adolescence
  3. attention-deficit disorders
  4. drug treatment/psychopharmacology

Authors

Details

Daniel Kim, M.S.
H. 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).
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Steven P. Cuffe, M.D.
H. 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).
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Pinar Keskinocak, Ph.D.
H. 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).
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Michael W. Naylor, M.D.
H. 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).
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Nicoleta Serban, Ph.D. [email protected]
H. 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).
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Notes

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

Competing Interests

Dr. Naylor is the psychiatric consultant to the Illinois Department of Children and Family Services (DCFS) Psychotropic Medication Consent Program and is paid via a contract between the University of Illinois Chicago and DCFS. The other authors report no financial relationships with commercial interests.

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