Do prescribers deprescribe psychotropic medication for children in foster care?. (March 2020)

• Record Type: Journal Article
• Authors: O'Brien, Conor; Rapp, John T.; Kierce, Erica D.
• Is Part Of: Developmental child welfare. Volume 2:Number 1(2020)
• Page Start: 3
• Page End: 20
• Publication Date: 2020-03
• Subjects: Deprescribing -- foster children -- polypharmacy -- psychotropic medication; Child welfare -- Periodicals; Poor children -- Social conditions -- Periodicals; Poor youth -- Social conditions -- Periodicals; Poor children -- Health and hygiene -- Periodicals; Poor youth -- Health and hygiene -- Periodicals; Poor youth -- Social conditions; Poor children -- Social conditions; Poor children -- Health and hygiene; Child welfare; Electronic journals; Periodicals; 362.705
• DOI: 10.1177/2516103219899668
• Languages: English
• ISSNs: 2516-1032

Abstract

Approximately one third of children in foster care in the U.S. receive psychotropic medication; however, few studies have evaluated the extent to which either the number or dosage of drugs changes across time. We conducted a retrospective descriptive study of Medicaid files for 30 individuals placed in a foster care system that included an analysis of 10 consecutive visits with a prescribing practitioner spanning 8–14 months. Specifically, we evaluated the data for evidence of deprescribing. Results indicate practitioners changed psychotropic medication during 70% of visits and most changes involved removing and adding psychotropic medication within the same class. Results also show 60% of visits across participants involved prescriptions for four or more psychotropic medications, whereas only 0.33% of trials involved no psychotropic medication. Furthermore, results show the mean number of psychotropic medications per foster child at the end of the study ( M = 3.97) did not decrease in comparison to the start of the study ( M = 3.53). Taken together, these results indicate that prescribers do not regularly engage in a clear deprescribing process for psychotropic medication when serving foster youth. We discuss some limitations to the current study and directions for future research on prescribing patterns with foster children.