3.57 Examining Demographic Factor Influences on Psychotropic Polypharmacy Rates for Youth With ASD

ObjectivesPrevious studies suggest that age is one of the known risk factors for psychotropic polypharmacy (PP), but it is not clear whether other demographic factors have significant effects on PP. In this study, the authors examined whether rates of PP in youth with ASD seen at the Seattle Children's Autism Center (SCAC) vary across select demographic factors.MethodsWe extracted data from the electronic medical record (EMR) for all patients with ASD ages 8 (preteen group) and 15 years old (midteen group), who were seen at the SCAC Psychiatry Clinic between 2010 and 2021. PP is defined using the cumulative number of unique medications prescribed in any given calendar year to an individual: youth with ≤2 psychotropic medications is categorized as low PP and those with ≥4 psychotropic medications as high PP. We examined the rate of low and high PP across the following demographic factors: age, sex assigned at birth, ethnicity, race, and insurance.ResultsTotals of 453 and 592 patients were included for the preteen and midteen groups respectively. Patients who are on 3 unique medications were dropped from further analysis, resulting in 392 patients in the 8-year-old group and 466 patients in the 15-year-old group. The mean number (SD) of unique psychotropic medications was 1.76 (1.52) in the preteen group and 2.55 (1.77) in the midteen group. High PP was exhibited by 12.7% of the preteen group and 25.9% of the midteen group. Cross-tabulation revealed effects of race and insurance only in the midteen group, but not in preteen group. In the midteen group, patients self-identified as White, and patients who had been on public insurance were more likely to exhibit high PP. These effects were not shown in the preteen group.ConclusionsThis study finds that patients who self-identified as White and patients who ever had public insurance are more likely to be on a higher number of psychotropic medications than those who are non-White and not having public insurance. However, these effects were only shown in older patients. Further study is necessary to investigate whether the number of psychotropic medications are directly related to factors such as access to other healthcare services in the community (eg, in-home applied behavior analysis, patient and family counseling/psychotherapy), the severity of core symptoms, and the presence of problem behaviors.ASD, RCR, DEMF ObjectivesPrevious studies suggest that age is one of the known risk factors for psychotropic polypharmacy (PP), but it is not clear whether other demographic factors have significant effects on PP. In this study, the authors examined whether rates of PP in youth with ASD seen at the Seattle Children's Autism Center (SCAC) vary across select demographic factors. Previous studies suggest that age is one of the known risk factors for psychotropic polypharmacy (PP), but it is not clear whether other demographic factors have significant effects on PP. In this study, the authors examined whether rates of PP in youth with ASD seen at the Seattle Children's Autism Center (SCAC) vary across select demographic factors. MethodsWe extracted data from the electronic medical record (EMR) for all patients with ASD ages 8 (preteen group) and 15 years old (midteen group), who were seen at the SCAC Psychiatry Clinic between 2010 and 2021. PP is defined using the cumulative number of unique medications prescribed in any given calendar year to an individual: youth with ≤2 psychotropic medications is categorized as low PP and those with ≥4 psychotropic medications as high PP. We examined the rate of low and high PP across the following demographic factors: age, sex assigned at birth, ethnicity, race, and insurance. We extracted data from the electronic medical record (EMR) for all patients with ASD ages 8 (preteen group) and 15 years old (midteen group), who were seen at the SCAC Psychiatry Clinic between 2010 and 2021. PP is defined using the cumulative number of unique medications prescribed in any given calendar year to an individual: youth with ≤2 psychotropic medications is categorized as low PP and those with ≥4 psychotropic medications as high PP. We examined the rate of low and high PP across the following demographic factors: age, sex assigned at birth, ethnicity, race, and insurance. ResultsTotals of 453 and 592 patients were included for the preteen and midteen groups respectively. Patients who are on 3 unique medications were dropped from further analysis, resulting in 392 patients in the 8-year-old group and 466 patients in the 15-year-old group. The mean number (SD) of unique psychotropic medications was 1.76 (1.52) in the preteen group and 2.55 (1.77) in the midteen group. High PP was exhibited by 12.7% of the preteen group and 25.9% of the midteen group. Cross-tabulation revealed effects of race and insurance only in the midteen group, but not in preteen group. In the midteen group, patients self-identified as White, and patients who had been on public insurance were more likely to exhibit high PP. These effects were not shown in the preteen group. Totals of 453 and 592 patients were included for the preteen and midteen groups respectively. Patients who are on 3 unique medications were dropped from further analysis, resulting in 392 patients in the 8-year-old group and 466 patients in the 15-year-old group. The mean number (SD) of unique psychotropic medications was 1.76 (1.52) in the preteen group and 2.55 (1.77) in the midteen group. High PP was exhibited by 12.7% of the preteen group and 25.9% of the midteen group. Cross-tabulation revealed effects of race and insurance only in the midteen group, but not in preteen group. In the midteen group, patients self-identified as White, and patients who had been on public insurance were more likely to exhibit high PP. These effects were not shown in the preteen group. ConclusionsThis study finds that patients who self-identified as White and patients who ever had public insurance are more likely to be on a higher number of psychotropic medications than those who are non-White and not having public insurance. However, these effects were only shown in older patients. Further study is necessary to investigate whether the number of psychotropic medications are directly related to factors such as access to other healthcare services in the community (eg, in-home applied behavior analysis, patient and family counseling/psychotherapy), the severity of core symptoms, and the presence of problem behaviors.ASD, RCR, DEMF This study finds that patients who self-identified as White and patients who ever had public insurance are more likely to be on a higher number of psychotropic medications than those who are non-White and not having public insurance. However, these effects were only shown in older patients. Further study is necessary to investigate whether the number of psychotropic medications are directly related to factors such as access to other healthcare services in the community (eg, in-home applied behavior analysis, patient and family counseling/psychotherapy), the severity of core symptoms, and the presence of problem behaviors.