One in three kids in foster care prescribed psychotropics

October 12, 2021

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More than a third of children on Medicaid in the foster care system were prescribed psychotropic drugs, a higher number than children on Medicaid outside the system, according to an AAP National Conference & Exhibition presentation.

Presenting author Rachael J. Keefe, MD, MPH, FAAP, assistant professor of pediatrics at Baylor College of Medicine and pediatrician at Texas Children’s Hospital, said in an interview with Healio that the inspiration for the study came from working with children in foster and family care in her clinical practice.

More than a third of children taking Medicaid in the foster care system are prescribed psychotropic drugs, more than four times more than their peers outside the system. Source: Adobe Stock

“We don’t normally research children in foster care, but Medicaid claims data was a fun way to see what was really going on within the population we serve,” Keefe said.

In the study, Keefe and colleagues analyzed claim data from two Medicaid-administered healthcare organizations in southeastern Texas. The largest provided Medicaid to children in the region and the second provided Medicaid exclusively to children in the foster care system.

The researchers then examined Medicaid’s claim files for six different classes of drugs: alpha agonists, anxiolytics, antidepressants, antipsychotics, mood stabilizers and stimulants.

A total of 388,914 children (mean age 8.2 years) on Medicaid and 8,426 children (mean age 7.7 years) in foster care were included in the study. When considering both age group and drug class, the researchers found that prescriptions for psychotropic drugs were more common in children in foster care compared to children on Medicaid.

Prescriptions were completed for an average of 2.8 different drug classes for children in foster care compared to 1.4 different drug classes for children not in the system.

The researchers also found that 35% of children on Medicaid and in foster care were prescribed psychotropic drugs to change their behavior or mood, more than four times the 8% of children on Medicaid out-of-system who were prescribed psychotropic drugs.

“I feel like I see it every day in my clinical practice, but it’s another thing to see it on paper,” Keefe said.

Keefe added that the answer was not to stop giving all psychotropic drugs to children.

“I think you need more supervision, more awareness of this over-medication,” Keefe. “This is a really unique study because there are no others comparing Medicaid populations that have the same geographic region. So theoretically you would expect kids on Medicaid to have the same rates across the board, not that big of a difference between kids in and from the foster care system.

Reference:

Children in foster care are much more likely to be prescribed psychotropic drugs than non-foster children in the Medicaid program. https://www.eurekalert.org/news-releases/930197. Published October 8, 2021. Accessed October 10, 2021.

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American Academy of Pediatrics National Conference and Exhibition

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