Observed Clinical and Health Services Outcomes in Pediatric Inpatients Treated with Atypical Antipsychotics: 1999–2003

Flanders, Scott C.; Findling, Robert L.; Youngstrom, Eric A.; Pandina, Gahan; Rupnow, Marcia F.T.; Jensik, Sarah E; Carlson, Gabrielle A.

doi:10.1089/cap.2006.17309

Cited by 3 publications

(2 citation statements)

References 27 publications

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“…Having a primary diagnosis of an eating disorder was noted for descriptive purposes. We identified patients who were prescribed a scheduled antipsychotic at discharge as a proxy for severity 15 (Supplemental Table 4). Medical comorbidity included any nonpsychiatric diagnosis coded during the encounter.…”

Section: Patient and Clinical Characteristicsmentioning

confidence: 99%

Health Care Reform, Length of Stay, and Readmissions for Child Mental Health Hospitalizations

Connell

Rutman

Whitlock

et al. 2020

Hospital Pediatrics

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BACKGROUND: Health care reform may impact inpatient mental health services by increasing access and changing insurer incentives. We examined whether implementation of the 2014 Affordable Care Act (ACA) was associated with changes in psychiatric length of stay (LOS) and 30-day readmissions for pediatric patients. METHODS: We conducted an interrupted time-series analysis to evaluate LOS and 30-day readmissions during the 30 months before and 24 months after ACA implementation, with a 6-month wash-out period, on patients aged 4 to 17 years who were discharged from the psychiatry unit of a children's hospital. Differences by payer (Medicaid versus non-Medicaid) were examined in moderated interrupted time series. Logistic regression was used to examine the association between psychiatric LOS and 30-day readmissions. RESULTS: There were 1874 encounters in the pre-ACA period and 2186 encounters in the post-ACA period. Compared with pre-ACA implementation, post-ACA implementation was associated with LOS that was significantly decreasing over time (pre-ACA versus post-ACA slope difference: 20.10 days per encounter per month [95% confidence interval 20.17 to 20.02]; P 5 .01), especially for Medicaid-insured patients (pre-ACA versus post-ACA slope difference: 20.14 days per encounter per month [95% confidence interval 20.26 to 20.01]; P 5 .03). The overall proportion of 30-day readmissions increased significantly (pre-ACA 6%, post-ACA 10%; P , .05 for the difference). We found no association between LOS and 30-day readmissions. CONCLUSIONS: ACA implementation was associated with a decline in psychiatric inpatient LOS over time, especially for those on Medicaid, and an increase in 30-day readmissions. LOS was not associated with 30-day inpatient readmissions. Further investigation to understand the drivers of these patterns is warranted.

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Section: Patient and Clinical Characteristicsmentioning

confidence: 99%

Health Care Reform, Length of Stay, and Readmissions for Child Mental Health Hospitalizations

Connell

Rutman

Whitlock

et al. 2020

Hospital Pediatrics

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“…11 Antipsychotic treatment in youth is associated with severe behavioral symptoms and more frequent acute psychiatric care episodes than are experienced by non-antipsychotic-treated mentally ill youth, suggesting that antipsychotic treatment may be an indicator of illness severity. 12 Although discontinuation of antipsychotic medications can lead to weight loss, this may occur at the expense of disabling symptom recurrence. 13 Given that antipsychotic discontinuation may not be a feasible option for many youth taking these medications, methods to mitigate treatment-related weight gain are necessary.…”

mentioning

confidence: 99%

Getting to More Effective Weight Management in Antipsychotic-Treated Youth: A Survey of Barriers and Preferences

et al. 2016

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Background: Mentally ill youth are at risk for developing obesity, especially when they require antipsychotic treatment; moreover, they may face unique challenges in adhering to behavioral weight loss interventions. The aims of this project were to characterize the challenges families of youth with psychiatric disorders face when engaging in weight loss treatment and to gather information on attitudes and preferences for weight management interventions in this population.Methods: We devised a telephone survey to evaluate caregiver-perceived barriers/challenges to and preferences for behavioral weight loss treatment in overweight or obese mentally ill youth ages 6-18 treated with an antipsychotic agent in an outpatient setting.Results: A total of 26 parents or primary caregivers completed the survey. The most commonly cited barriers to participation in physical activity (PA) and maintaining a healthy diet were child's dislike of PA and child's preference for energy-dense foods, respectively, which were impacted by psychiatric symptoms. Preferences for weight loss treatment included individualized, prescribed meal plans and shopping lists, and exercise support/demonstration, with a preference for Internet or cell phone applications to help with monitoring food intake and exercise.Conclusions: These results suggest that targets for obesity treatment in this population include individualized, specific support that takes into account the child's motivation, which is effected by psychiatric symptoms. Tools for providing support may include the use of telehealth visits and mobile device applications for self-monitoring.

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Prescriptions d'antipsychotiques chez l'enfant et l'adolescent

Bonnot¹,

Consoli²,

Cohen³

2011

EMC - Psychiatrie

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Observed Clinical and Health Services Outcomes in Pediatric Inpatients Treated with Atypical Antipsychotics: 1999–2003

Cited by 3 publications

References 27 publications

Health Care Reform, Length of Stay, and Readmissions for Child Mental Health Hospitalizations

Health Care Reform, Length of Stay, and Readmissions for Child Mental Health Hospitalizations

Getting to More Effective Weight Management in Antipsychotic-Treated Youth: A Survey of Barriers and Preferences

Prescriptions d'antipsychotiques chez l'enfant et l'adolescent

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