Initiation and change of psychotropic medication regimens among adolescents in inpatient care.
OBJECTIVE
The purpose of this study was to compare clinical and service utilization profiles of adolescents admitted to inpatient treatment with and without a psychotropic medication regimen, and estimate correlates of medication use separately for the two groups.


METHODS
Comprehensive data on clinical characteristics and service utilization of 517 adolescents enrolled in Medicaid who were admitted to three inpatient hospitals (one for-profit and two nonprofit) in a mid-Atlantic state were used. Medication correlates were examined with bivariate statistics (chi-square and t-test) and multivariate logistic regressions.


RESULTS
Psychotropic medication was prescribed for the majority (90.5%) of adolescents at discharge. During their inpatient stay, 76.3% of the youths who were not on medication at admission (n = 190) initiated medication use, and 45% admitted with prior medication (n = 327) had a medication change. Adolescents admitted with and without medication differed on all sociodemographic and clinical characteristics except age, suicidality, and hospital. Controlling on demographic, clinical, and service history characteristics, hospital setting was the only correlate significantly associated with both initiation and change.


CONCLUSIONS
Institutional factors may be more important than clinical factors in appraising medication patterns in inpatient settings. Interventions to ensure the development and implementation of medication management guidelines may need to be tailored to the climate and culture of the provider organization as well as directly to individual practitioners, parents or adolescents themselves.
Warner
Lynn A
LA
School of Social Welfare, University at Albany-SUNY, 135 Washington Avenue, Albany, NY 12222, USA. lwarner@uamail.albany.edu
Fontanella
Cynthia A
CA
Pottick
Kathleen J
KJ
D000293:Adolescent; D002648:Child; D003627:Data Interpretation, Statistical; D004363:Drug Utilization; D005260:Female; D006760:Hospitalization; D006778:Hospitals, Psychiatric; D006801:Humans; D007297:Inpatients; D008297:Male; D001523:Mental Disorders / Q000145:classification / Q000188:drug therapy*; D008605:Mental Health Services / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D011569:Psychiatric Status Rating Scales; D011619:Psychotropic Drugs / Q000009:adverse effects / Q000627:therapeutic use*; D012959:Socioeconomic Factors
D011619:Psychotropic Drugs