Abstract
The purpose of our study is to use Medicaid data to examine the relationship between race and (a) whether youth with schizophrenia or depression diagnoses receive anti-psychotic and antidepressant prescriptions and (b) adherence to anti-psychotics and antidepressants. The analysis is based on claims files from January 1, 2000 through June 30, 2001. To assess adherence, we used the Proportion of Days Covered (PDC) measure. Multivariable logistic regression was used to analyze the data. Black children with schizophrenia were significantly less likely to be adherent to anti-psychotics during a quarter than White children. White children with depression were significantly more likely to receive an antidepressant prescription and they were significantly more adherent during a quarter than Black children. Providers should make sure to investigate both youth and caregiver concerns, fears, and barriers to using these medications and work with the families to develop strategies to improve medication use among youth.
Similar content being viewed by others
References
Anderson, R., & Newman, J. (1973). Societal and individual determinants of medical care utilization in the United States. Milbank Memorial Fund Quarterly: Health and Society, 51, 95–124.
Aparasu, R. R., Mort, J. R., & Brandt, H. (2003). Psychotropic prescription use by community-dwelling elderly in the United States. Journal of the American Geriatrics Society, 51, 671–677.
Benner, J. S., Glynn, R. J., Mogun, H., Neumann, P. J., Weinstein, M. C., & Avorn, J. (2002). Long-term persistence in use of statin therapy in elderly patients. Journal of the American Medical Association, 288(4), 455–461.
Bush, P. J., & Osterweis, M. (1978). Pathways to medicine use. Journal of Health and Social Behavior, 19, 179–189.
Charach, A., Volpe, T., Boydell, K. M., & Gearing, R. E. (2008). A theoretical approach to medication adherence for children and youth with psychiatric disorders. Harvard Review of Psychiatry, 16(2), 126–135.
Conn, K. M., Halterman, J. S., Fisher, S. G., Yoos, L., Chin, N. P., & Szilagyi, P. G. (2005). Parental beliefs about medications and medication adherence among urban children with youth. Ambulatory Pediatrics, 5, 306–310.
Cooper, L. A., Gonzales, J. J., Gallo, J. J., Rost, K. M., Meredith, L. S., Rubenstein, L. V., et al. (2003). The acceptability of treatment for depression among African-American, hispanic, and white primary care patients. Medical Care, 41(4), 479–489.
Corbie-Smith, G., Thomas, S. B., & St George, D. M. (2002). Distrust, race and research. Archives of Internal Medicine, 162(21), 2458–2463.
Costello, I., Wong, I. C. K., & Nunn, A. J. (2004). A literature review to identify interventions to improve the use of medicines in children. Child: Care, Health and Development, 30(6), 647–665.
DiMatteo, M. R. (2004). Variations in patients’ adherence to medical recommendations: A quantitative review of 50 years of research. Medical Care, 42(3), 197–199.
Goodwin, R., Gould, M. S., Blanco, C., & Olfson, M. (2001). Prescription of psychotropic medications to youths in office-based practice. Psychiatric Services, 52(8), 1081–1187.
Gray, S. L., Hanlon, J., Fillenbaum, G. G., Wall, W. E., Jr, & Bales, C. (1996). Predictors of nutritional supplement use by the elderly. Pharmacotherapy, 16, 715–720.
Hahn, B. A. (1995). Children’s health: Racial and ethnic differences in the use of prescription medications. Pediatrics, 95, 727–732.
Hudson, J. L., Miller, E., & Kirby, J. B. (2007). Explaining racial and ethnic differences in children’s use of stimulant medications. Medical Care, 45(11), 1068–1075.
Marhefka, S., Koenig, L. J., Allison, S., Bachanas, P., Bulterys, M., Bettica, L., et al. (2008). Family experiences with pediatric antiretroviral therapy: responsibilities, barriers, and strategies for remembering medications. AIDS Patient Care and STDs, 22(8), 637–647.
Martin, A., Van Hoof, T., Stubbe, D., Sherwin, T., & Scahill, L. (2003). Multiple psychotropic pharmacotherapy among child and adolescent enrollees in Connecticut medicaid managed care. Psychiatric Services, 54(1), 72–77.
Martin B.C, Wiley-Exley E., Sichards S., Domino M.E., Carey T.S., Sleath B.L. (2009). Contrasting measures of adherence with simple drug use, medication switching, and therapeutic duplication. Annals of Pharmacotherapy, 43(1), 36–44.
Matsui, D. (2007). Current issues in pediatric medication adherence. Pediatric Drugs, 9(5), 283–288.
Meichenbaum, D., & Turk, D. (1987). Facilitating Treatment Adherence. NY: Plenum.
Nemeroff, C. B., Kalali, A., Keller, M. B., Charney, D. S., Lenderts, S. E., Cascade, E. F., et al. (2007). Impact of publicity concerning pediatric suicidality data on physician practice patterns in the United States. Archives of General Psychiatry, 64, 466–472.
Olfson, M., Marcus, S. C., & Druss, B. G. (2008). Effects of food and drug administration warnings of antidepressant use in a nation sample. Archives of General Psychiatry, 65(1), 94–101.
Peterson, A. M., Nau, D. P., Cramer, J. A., Benner, J., Gwadry-Sridhar, F., & Nichol, M. (2007). A checklist for medication compliance and persistence studies using retrospective database. Value Health, 10(1), 3–12.
Ragjavan, R., Zima, B. T., Andersen, R. M., Leibowitz, A. A., Schuster, M. A., & Landsverk, J. (2005). Psychotropic medication use in a national probability sample of children in the child welfare system. Journal of Child and Adolescent Psychopharmacology, 15(1), 97–106.
Rushton, J. L., & Whitmire, T. (2001). Pediatric stimulant and selective serotonin reuptake inhibitor prescription trends. Archives of Pediatrics and Adolescent Medicine, 155, 560–565.
Schnittker, J. (2003). Misgivings of medicine?: African Americans’ skepticism of psychiatric medication. Journal of Health and Social Behavior, 44, 506–524.
Sleath, B., Bush, P. J., & Pradel, F. G. (2003). Communicating with children about medicines: A pharmacist’s perspective. American Journal of Health-Systems Pharmacy, 60, 604–607.
Smith, S. R., & Kirking, D. M. (1999). Access and use of medications in HIV disease. Health Services Research, 34, 123–144.
Svarstad, B. L., Chewning, B. A., & Claesson, C. (1999). The brief medication questionnaire: A tool for screening patient adherence and barriers to adherence. Patient Education Counseling, 37(2), 113–124.
Zito, J. M., Safer, D. J., dosReis, S., & Riddle, M. A. (1998). Racial disparity in psychotropic medication prescribed for youths with medicaid insurance in Maryland. Journal of American Academy of Child & Adolescent Psychiatry, 37(2), 179–184.
Zito, J. M., Safer, D. J., Zuckerman, I. H., Gardner, J. F., & Soeken, K. (2005). Effect of medicaid eligibility category on racial disparities in the use of psychotropic medications among youths. Psychiatric Services, 56(2), 157–163.
Acknowledgments
This study was funded by the Changes in Health Care Financing & Organization Initiative at the Robert Wood Johnson Foundation and Academy Health. Additional support was received by Dr. Domino from NIMH 5K01MH65639.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Sleath, B., Domino, M.E., Wiley-Exley, E. et al. Antidepressant and Antipsychotic Use and Adherence Among Medicaid Youths: Differences by Race. Community Ment Health J 46, 265–272 (2010). https://doi.org/10.1007/s10597-009-9277-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10597-009-9277-5