WHAT'S KNOWN ON THIS SUBJECT: Psychotropic use is common and increasing in children with mental disorders but little is known about the long-term patterns of psychotropic use and polypharmacy among commercially insured children with autism spectrum disorders. WHAT THIS STUDY ADDS:Among 33 565 children with autism spectrum disorders, 64% used psychotropic medications and 35% had evidence of polypharmacy. Older children and those who had seizures, attention-deficit disorders, anxiety, bipolar disorder, or depression had increased risk of psychotropic use and polypharmacy.abstract OBJECTIVE: The objectives of this study were to examine rates and predictors of psychotropic use and multiclass polypharmacy among commercially insured children with autism spectrum disorders (ASD).METHODS: This retrospective observational study used administrative medical and pharmacy claims data linked with health plan enrollment and sociodemographic information from 2001 to 2009. Children with ASD were identified by using a validated ASD case algorithm. Psychotropic polypharmacy was defined as concurrent medication fills across $2 classes for at least 30 days. Multinomial logistic regression was used to model 5 categories of psychotropic use and multiclass polypharmacy. RESULTS:Among 33 565 children with ASD, 64% had a filled prescription for at least 1 psychotropic medication, 35% had evidence of psychotropic polypharmacy ($2 classes), and 15% used medications from $3 classes concurrently. Among children with polypharmacy, the median length of polypharmacy was 346 days. Older children, those who had a psychiatrist visit, and those with evidence of cooccurring conditions (seizures, attention-deficit disorders, anxiety, bipolar disorder, or depression) had higher odds of psychotropic use and/or polypharmacy.CONCLUSIONS: Despite minimal evidence of the effectiveness or appropriateness of multidrug treatment of ASD, psychotropic medications are commonly used, singly and in combination, for ASD and its cooccurring conditions. Our results indicate the need to develop standards of care around the prescription of psychotropic medications to children with ASD. Pediatrics 2013;132:833-840

Since 1957, the National Health Interview Survey (NHIS), sponsored by the Centers for Disease Control and Prevention (CDC)’s National Center for Health Statistics (NCHS), has been the primary source of information for monitoring health and health care use of the U.S. population at the national level. The passage of the Patient Protection and Affordable Care Act (ACA) in 2010 generated new needs for data to monitor its implementation and evaluate its effectiveness. In response, the NCHS has taken steps to enhance the content of the NHIS in several key areas and positioned the NHIS as a source of population health information at the national and state levels. This paper reviews recent changes to the NHIS that support enhanced health reform monitoring, including new questions and response categories, sampling design changes to improve state-level analysis, and enhanced dissemination activities. We conclude with a discussion about the importance of the NHIS, the continued need for state-level analysis, and suggestions for future consideration.

No abstract

No abstract

No abstract