Adherence to antipsychotic laboratory monitoring guidelines in children and youth: a population-based study

被引:3
|
作者
Antoniou, Tony [1 ,2 ,3 ,4 ]
Wang, Tianru [2 ]
Pajer, Kathleen [5 ,6 ]
Gardner, William [2 ,7 ]
Lunsky, Yona [2 ,8 ,9 ]
Penner, Melanie [10 ,11 ]
Tadrous, Mina [2 ,12 ]
Mamdani, Muhammad [1 ,2 ,12 ,13 ,14 ,15 ]
Juurlink, David N. [2 ,11 ,16 ]
Gomes, Tara [1 ,2 ,12 ,15 ]
机构
[1] St Michaels Hosp, Li Ka Shing Knowledge Inst, Toronto, ON, Canada
[2] Inst Clin Evaluat Sci, Toronto, ON, Canada
[3] Univ Toronto, Dept Family & Community Med, Toronto, ON, Canada
[4] St Michaels Hosp, Dept Family & Community Med, Toronto, ON, Canada
[5] Childrens Hosp Eastern Ontario Res Inst, Ottawa, ON, Canada
[6] Univ Ottawa, Dept Psychiat, Ottawa, ON, Canada
[7] Univ Ottawa, Sch Epidemiol & Publ Hlth, Ottawa, ON, Canada
[8] Azrieli Adult Neurodev Ctr, Ctr Addict & Mental Hlth, Toronto, ON, Canada
[9] Univ Toronto, Dept Psychiat, Toronto, ON, Canada
[10] Holland Bloorview Kids Rehabil Hosp, Bloorview Res Inst, Autism Res Ctr, Toronto, ON, Canada
[11] Univ Toronto, Dept Pediat, Toronto, ON, Canada
[12] Univ Toronto, Leslie Dan Fac Pharm, Toronto, ON, Canada
[13] Li Ka Shing Ctr Healthcare Analyt Res & Training, Unity Hlth Toronto, Toronto, ON, Canada
[14] Univ Toronto, Temerty Fac Med, Toronto, ON, Canada
[15] Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada
[16] Univ Toronto, Dept Med, Toronto, ON, Canada
来源
FRONTIERS IN PSYCHIATRY | 2023年 / 14卷
基金
加拿大健康研究院;
关键词
antipsychotic agents; adverse effects; drug monitoring; adolescent; child; guidelines as topic; 2ND-GENERATION ANTIPSYCHOTICS; ADOLESCENTS; DISORDERS; CHILDHOOD; BURDEN; SAFETY; RISK;
D O I
10.3389/fpsyt.2023.1172559
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
BackgroundIn 2011, the Canadian Alliance for Monitoring Effectiveness and Safety of Antipsychotics in Children (CAMESA) published guidelines for the metabolic monitoring of antipsychotic-treated children and youth. Population-based studies examining adherence to these guidelines are needed to ensure the safe use of antipsychotics in children and youth. MethodsWe conducted a population-based study of all Ontario residents aged 0 to 24 who were newly dispensed an antipsychotic between April 1, 2018, and March 31, 2019. We estimated prevalence ratios (PRs) and 95% confidence intervals (CI) associating sociodemographic characteristics with the receipt of baseline and follow-up (3- and 6-month) laboratory testing using log-Poisson regression models. ResultsOverall, 6,505 of 27,718 (23.5%) children and youth newly dispensed an antipsychotic received at least one guideline-recommended baseline test. Monitoring was more prevalent among individuals aged 10 to 14 years (PR 1.20; 95% CI 1.04 to 1.38), 15 to 19 years (PR 1.60; 95% CI 1.41 to 1.82), and 20 to 24 years (PR 1.71; 95% CI 1.50 to 1.94) compared to children under the age of 10. Baseline monitoring was associated with mental health-related hospitalizations or emergency department visits in the year preceding therapy (PR 1.76; 95% CI 1.65 to 1.87), a prior diagnosis of schizophrenia (PR 1.20; 95% CI 1.14 to 1.26) or diabetes (PR 1.35; 95% CI 1.19 to 1.54), benzodiazepine use (PR 1.13; 95% CI 1.04 to 1.24), and receipt of a prescription from a child and adolescent psychiatrist or developmental pediatrician versus a family physician (PR 1.41; 95% CI 1.34 to 1.48). Conversely, monitoring was less frequent in individuals co-prescribed stimulants (PR 0.83; 95% CI 0.75 to 0.91). The prevalence of any 3- and 6-month follow-up monitoring among children and youth receiving continuous antipsychotic therapy at these time points was 13.0% (1,179 of 9,080) and 11.4% (597 of 5,261), respectively. Correlates of follow-up testing were similar to those of baseline monitoring. ConclusionMost children initiating antipsychotic therapy do not receive guideline-recommended metabolic laboratory monitoring. Further research is needed to understand reasons for poor guideline adherence and the role of clinician training and collaborative service models in promoting best monitoring practices.
引用
收藏
页数:13
相关论文
共 50 条
  • [31] ADHERENCE TO SURVEILLANCE GUIDELINES AFTER RADICAL CYSTECTOMY: A POPULATION-BASED ANALYSIS
    Ehdaie, Behfar
    Atoria, Coral
    Lowrance, William
    Feifer, Andrew
    Bajorin, Dean
    Bochner, Bernard
    Donat, S. Machele
    Dalbagni, Guido
    Elkin, Elena
    JOURNAL OF UROLOGY, 2012, 187 (04): : E768 - E769
  • [32] Childhood behavior disorders and injuries among children and youth: A population-based study
    Brehaut, JC
    Miller, A
    Raina, P
    McGrail, KM
    PEDIATRICS, 2003, 111 (02) : 262 - 269
  • [33] Adherence to guidelines for androgen deprivation therapy after radical prostatectomy: Swedish population-based study
    Lycken, Magdalena
    Drevin, Linda
    Garmo, Hans
    Larsson, Anders
    Andren, Ove
    Holmberg, Lars
    Bill-Axelson, Anna
    SCANDINAVIAN JOURNAL OF UROLOGY, 2020, 54 (03) : 208 - 214
  • [34] Audiometric Testing Guideline Adherence in Children Undergoing Tympanostomy Tubes: A Population-Based Study
    Beyea, Jason A.
    Rosen, Emily
    Stephens, Trina
    Paul Nguyen
    Hall, Stephen F.
    OTOLARYNGOLOGY-HEAD AND NECK SURGERY, 2018, 158 (06) : 1127 - 1133
  • [35] Population-based study of repeat laboratory testing
    van Walraven, C
    Raymond, M
    CLINICAL CHEMISTRY, 2003, 49 (12) : 1997 - 2005
  • [36] Antipsychotic polypharmacy in a regional health service: a population-based study
    Miguel Bernardo
    Anna Coma
    Cristina Ibáñez
    Corinne Zara
    Josep Maria Bari
    Antoni Serrano-Blanco
    BMC Psychiatry, 12
  • [37] Cardiometabolic screening and monitoring in patients prescribed antipsychotic drugs in primary care: A population-based cohort study
    Ali, Ruba Azfr
    Jalal, Zahraa
    Chandan, Joht Singh
    Subramanian, Anuradhaa
    Adderley, Nicola J.
    Nirantharakumar, Krishnarajah
    Gokhale, Krishna M.
    Paudyal, Vibhu
    COMPREHENSIVE PSYCHIATRY, 2023, 127
  • [38] Antipsychotic polypharmacy in a regional health service: a population-based study
    Bernardo, Miguel
    Coma, Anna
    Ibanez, Cristina
    Zara, Corinne
    Maria Bari, Josep
    Serrano-Blanco, Antoni
    BMC PSYCHIATRY, 2012, 12
  • [39] Adherence to clinical practice guidelines: a population-based study of socio-economic inequalities in breast cancer
    Petrova, D.
    Redondo Sanchez, D.
    Rodriguez-Barranco, M.
    Carulla, M.
    Guevara, M.
    Lopez de Munain, A.
    Vizcaino, A.
    Marcos-Gragera, R.
    Gonzalez-Flores, E.
    Sant, M.
    Pollan, M.
    Sanchez-Perez, M. J.
    EUROPEAN JOURNAL OF CANCER, 2024, 200 : 97 - 97
  • [40] Contraindications to metformin therapy in patients with Type 2 diabetes - a population-based study of adherence to prescribing guidelines
    Emslie-Smith, AM
    Boyle, DIR
    Evans, JMM
    Sullivan, F
    Morris, AD
    DIABETIC MEDICINE, 2001, 18 (06) : 483 - 488