Metabolic monitoring training program implementation in the community setting was associated with improved monitoring in second-generation antipsychotic-treated children.

Objective: To determine whether implementation of a metabolic monitoring training program (MMTP) in an urban community-based setting improved monitoring in children treated with second-generation antipsychotics (SGAs) and changed prescription rates of SGAs to children.

Method: The MMTP was implemented in the Vancouver Coastal Health Child and Youth Mental Health Teams (CYMHTs) on January 1, 2009. A retrospective review of paper charts and electronic records for children seen at the CYMHTs from September 1, 2007, to May 1, 2010, was performed to collect the following data: age, sex, foster care, immigrant status, Axis I diagnosis, and medications.

Do Hospital and Community SSRI Usage Patterns in Children and Adolescents Match the Evidence?

Objectives: 1) To review SSRI prescribing patterns for children and adolescents in our hospital and provincial prescription database and 2) To evaluate whether prescribing practices are consistent with expectations, based on published evidence and practice recommendations.

Methods: A PubMed online search was conducted to obtain all randomized controlled trials assessing efficacy of SSRI use in children and adolescents. The inpatient hospital pharmacy database at BC Children's Hospital (BCCH) and the BC Pharmacare database were used to identify all unique patients (under 19 years of age) seen in the inpatient department of psychiatry at BCCH or as outpatients in the province of BC receiving SSRI prescriptions between 2005-2009.

First do no harm: promoting an evidence-based approach to atypical antipsychotic use in children and adolescents.

Objectives: To review the evidence for efficacy and metabolic effects of atypical antipsychotics (AAPs), and to propose a metabolic monitoring protocol for AAP use in children and adolescents.

Methods: A PubMed search was performed to obtain all studies related to efficacy, metabolic side-effects, and monitoring in those less than 18 years of age.

Results: There are no approved indications for AAP use in children and adolescents in Canada.

Priority-setting for children's mental health: clinical usefulness and validity of the priority criteria score.

Objective: The 17-item PCS was designed for priority-setting and queue management of children and adolescents referred for mental health services. Here we assess aspects of the validity of the Children's Mental Health (CMH) Priority Criteria Score (PCS), developed by the Western Canada Waiting List Project (WCWL). The PCS was evaluated across clinical settings of increasing acuity and in terms of its relationship to two variables reflecting criteria-related validity and actual wait times.

Lining up for children's mental health services: a tool for prioritizing waiting lists.

Objective: The Western Canada Waiting List Project (WCWL) is a federally funded partnership of 19 health-related organizations that was created to develop tools to manage waiting lists for five types of health services.

Method: The children's mental health (CMH) panel developed and tested a set of standardized clinical criteria for setting priorities among patients awaiting CMH services. The criteria were applied to 817 patients by 92 mental health professionals in three western provinces.