Safer and targeted use of antipsychotics in youth: an embedded, pragmatic randomized trial / Abisola E. IDU ; R. Yates COLEY ; Kara L. CUSHING-HAUGEN ; Deborah KING ; Ashley GLASS ; Rebecca C. PHILLIPS ; Anne D. RENZ ; Chester J. PABINIAK ; Vina F. GRAHAM ; Ella E. THOMPSON ; James D. RALSTON ; Gregory E. SIMON ; Erin S. GONZALEZ ; Kathleen M. MYERS ; Arne BECK ; LeeAnn M. QUINTANA ; Arthur J. RUNKLE ; Megan ROGERS ; Deirdre M. FOSTER ; Gregory N. CLARKE ; Stefan MASSIMINO ; Phillip M. CRAWFORD ; Julie A. CAVESE ; Anthony R. CORDARO ; Laura I. CHAVEZ ; Kelly J. KELLEHER ; Nadine SCHWARTZ ; Kristina R. JINER ; Swan Bee LIU ; Sara CONDRAC ; Robert J. HILT in Journal of Child Psychology and Psychiatry, 66-3 (March 2025)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 66-3 (March 2025) . - p.301-310 Titre : Safer and targeted use of antipsychotics in youth: an embedded, pragmatic randomized trial Type de document : Texte imprimé et/ou numérique Auteurs : Abisola E. IDU, Auteur ; R. Yates COLEY, Auteur ; Kara L. CUSHING-HAUGEN, Auteur ; Deborah KING, Auteur ; Ashley GLASS, Auteur ; Rebecca C. PHILLIPS, Auteur ; Anne D. RENZ, Auteur ; Chester J. PABINIAK, Auteur ; Vina F. GRAHAM, Auteur ; Ella E. THOMPSON, Auteur ; James D. RALSTON, Auteur ; Gregory E. SIMON, Auteur ; Erin S. GONZALEZ, Auteur ; Kathleen M. MYERS, Auteur ; Arne BECK, Auteur ; LeeAnn M. QUINTANA, Auteur ; Arthur J. RUNKLE, Auteur ; Megan ROGERS, Auteur ; Deirdre M. FOSTER, Auteur ; Gregory N. CLARKE, Auteur ; Stefan MASSIMINO, Auteur ; Phillip M. CRAWFORD, Auteur ; Julie A. CAVESE, Auteur ; Anthony R. CORDARO, Auteur ; Laura I. CHAVEZ, Auteur ; Kelly J. KELLEHER, Auteur ; Nadine SCHWARTZ, Auteur ; Kristina R. JINER, Auteur ; Swan Bee LIU, Auteur ; Sara CONDRAC, Auteur ; Robert J. HILT, Auteur Article en page(s) : p.301-310 Langues : Anglais (eng) Mots-clés : Antipsychotic  guidelines  consulting  accessibility Index. décimale : PER Périodiques Résumé : Background Antipsychotic medications (AP) are inappropriately prescribed to young people. The goal of this pragmatic trial was to test a four-component approach to improved targeting of antipsychotic prescribing to people aged ?3 and <18?years. Methods Clinicians in four health systems were cluster randomized by the number of previous AP orders and service line ? specialty mental health and all others. Intervention arm clinicians received a best practice alert and child psychiatrist consultation and feedback. Families received system navigation and expedited access to psychotherapy. Primary outcomes were total days' supply of AP medication and proportion of youth with any AP supply at 6?months. We estimated the log-odds of AP use at 6?months and the relative rate of AP over 6?months. The Safer and Targeted Use of Antipsychotics in Youth (SUAY) trial took place between 3/2018 and 12/2020. Results The trial enrolled 733 patients. The odds ratio (OR) comparing use at 6?months was 0.75 (95% CI: 0.52, 1.09). The mean number of days using AP was 118.5 for intervention patients and 128.2 for control patients (relative risk [RR]?=?0.92; 95% CI: 0.81?1.04). Exploratory heterogeneity of treatment effects (HTE) was not detected in groups defined by age, gender, provider specialty, and insurance type. HTE by race/ethnicity was present: among youth of color, mean days' supply was 103.2 for intervention arm and 131.2 for the control arm (RR 0.79, 95% CI: 0.67?0.93). Among secondary outcomes, only new psychotherapy referrals differed with 44.3% (n?=?154) of intervention participants having a new order for psychotherapy compared to 33.5% (n?=?129) in the control arm (OR 1.47: 95% CI: 1.01?2.14). Conclusions This intervention did not result in less AP use at 6?months or a reduction in the days' supply of AP medication, although psychotherapy orders increased. The intervention may be effective for some subgroups. En ligne : https://doi.org/10.1111/jcpp.14059 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=548 [article] Safer and targeted use of antipsychotics in youth: an embedded, pragmatic randomized trial [Texte imprimé et/ou numérique] / Abisola E. IDU, Auteur ; R. Yates COLEY, Auteur ; Kara L. CUSHING-HAUGEN, Auteur ; Deborah KING, Auteur ; Ashley GLASS, Auteur ; Rebecca C. PHILLIPS, Auteur ; Anne D. RENZ, Auteur ; Chester J. PABINIAK, Auteur ; Vina F. GRAHAM, Auteur ; Ella E. THOMPSON, Auteur ; James D. RALSTON, Auteur ; Gregory E. SIMON, Auteur ; Erin S. GONZALEZ, Auteur ; Kathleen M. MYERS, Auteur ; Arne BECK, Auteur ; LeeAnn M. QUINTANA, Auteur ; Arthur J. RUNKLE, Auteur ; Megan ROGERS, Auteur ; Deirdre M. FOSTER, Auteur ; Gregory N. CLARKE, Auteur ; Stefan MASSIMINO, Auteur ; Phillip M. CRAWFORD, Auteur ; Julie A. CAVESE, Auteur ; Anthony R. CORDARO, Auteur ; Laura I. CHAVEZ, Auteur ; Kelly J. KELLEHER, Auteur ; Nadine SCHWARTZ, Auteur ; Kristina R. JINER, Auteur ; Swan Bee LIU, Auteur ; Sara CONDRAC, Auteur ; Robert J. HILT, Auteur . - p.301-310. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 66-3 (March 2025) . - p.301-310 Mots-clés : Antipsychotic  guidelines  consulting  accessibility Index. décimale : PER Périodiques Résumé : Background Antipsychotic medications (AP) are inappropriately prescribed to young people. The goal of this pragmatic trial was to test a four-component approach to improved targeting of antipsychotic prescribing to people aged ?3 and <18?years. Methods Clinicians in four health systems were cluster randomized by the number of previous AP orders and service line ? specialty mental health and all others. Intervention arm clinicians received a best practice alert and child psychiatrist consultation and feedback. Families received system navigation and expedited access to psychotherapy. Primary outcomes were total days' supply of AP medication and proportion of youth with any AP supply at 6?months. We estimated the log-odds of AP use at 6?months and the relative rate of AP over 6?months. The Safer and Targeted Use of Antipsychotics in Youth (SUAY) trial took place between 3/2018 and 12/2020. Results The trial enrolled 733 patients. The odds ratio (OR) comparing use at 6?months was 0.75 (95% CI: 0.52, 1.09). The mean number of days using AP was 118.5 for intervention patients and 128.2 for control patients (relative risk [RR]?=?0.92; 95% CI: 0.81?1.04). Exploratory heterogeneity of treatment effects (HTE) was not detected in groups defined by age, gender, provider specialty, and insurance type. HTE by race/ethnicity was present: among youth of color, mean days' supply was 103.2 for intervention arm and 131.2 for the control arm (RR 0.79, 95% CI: 0.67?0.93). Among secondary outcomes, only new psychotherapy referrals differed with 44.3% (n?=?154) of intervention participants having a new order for psychotherapy compared to 33.5% (n?=?129) in the control arm (OR 1.47: 95% CI: 1.01?2.14). Conclusions This intervention did not result in less AP use at 6?months or a reduction in the days' supply of AP medication, although psychotherapy orders increased. The intervention may be effective for some subgroups. En ligne : https://doi.org/10.1111/jcpp.14059 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=548

---

1 (1 - 1 / 1)