Psychotropic Treatment Pattern in Medicaid Pediatric Patients With Concomitant ADHD and ODD/CD.
To describe psychotropic treatment pattern and evaluate the association of socio-demographic factors and psychotropic combination therapy in children with ADHD and oppositional defiant disorder/conduct disorder (ODD/CD).



This is a cross-sectional drug utilization study based on Medicaid fee-for-service programs in 26 U.S. states (1999-2006). Children aged 4 to 18 with concomitant ADHD and ODD/CD were included. We calculated the prevalence of psychotropic drugs and used logistic regression to evaluate the role of socio-demographic factors in psychotropic combination therapy.



We identified 121,740 children with ADHD and ODD/CD (140,777 person-years). The period prevalence of "no psychotropic therapy," psychotropic monotherapy, and psychotropic dual therapy was 38.1%, 44.7%, and 9.0%, respectively. The most common drug class was stimulants. Whites, males, and children in foster care were more likely to use psychotropic combination therapy. State-level variation was observed.



"No psychotropic therapy" and stimulants dominate treatment choices in children with ADHD and ODD/CD. Socio-demographic characteristics are associated with combination psychotropic therapy.
1 University of Florida, Gainesville, FL, USA.
Xinyue
X
Liu
1 University of Florida, Gainesville, FL, USA.
Vaishali
V
Shah
1 University of Florida, Gainesville, FL, USA.
Paul
P
Kubilis
1 University of Florida, Gainesville, FL, USA.
Dandan
D
Xu
1 University of Florida, Gainesville, FL, USA.
Regina
R
Bussing
1 University of Florida, Gainesville, FL, USA.
Almut G
AG
Winterstein
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000453:epidemiology; D019958:Attention Deficit and Disruptive Behavior Disorders / Q000150:complications / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D019955:Conduct Disorder / Q000188:drug therapy* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004363:Drug Utilization; D005260:Female; D006801:Humans; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data*; D015995:Prevalence; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D014481:United States
D000697:Central Nervous System Stimulants; D011619:Psychotropic Drugs
ADHD; Medicaid; conduct disorder; oppositional defiant disorder; psychotropic drugs