Front Pediatr
Division of Developmental Behavioral Pediatrics, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, United States.
Published: March 2022
Objectives: To describe medication management of children diagnosed with anxiety and/or depression by primary care providers within a primary care network.
Study Design/methods: We performed a retrospective cross-sectional analysis of electronic health record (EHR) structured data from all children seen at least twice in a 4-year observation period within a network of primary care clinics in Northern California. For children who had visit diagnoses of anxiety, depression, anxiety+depression or symptoms characteristic of these conditions, we analyzed the rates and types of medications prescribed. A logistic regression model considered patient variables for the combined sample.
Results: Of all patients 6-18 years old ( = 59,484), 4.4% ( = 2,635) had a diagnosis of anxiety only, 2.4% ( = 1,433) depression only, and 1.2% ( = 737) both anxiety and depression (anxiety + depression); 18% of children with anxiety and/or depression had comorbid ADHD. A total of 15.0% with anxiety only ( = 357), 20.5% with depression only ( = 285), and 47.4% with anxiety+depression (n=343) were prescribed a psychoactive non-stimulant medication. For anxiety and depression only, the top three medications prescribed were sertraline, fluoxetine, and citalopram. For anxiety + depression, the top three medications prescribed were citalopram, sertraline, and escitalopram. Frequently prescribed medications also included benzodiazepines. Logistic regression modeling showed that the depression only and anxety + depression categories had increased likelihood of medication prescription. Older age and mental health comorbidities were independently associated with increased likelihood of medication prescription.
Conclusions: In this network, ~8% of children carried a diagnosis of anxiety and/or depression. Medication choices generally aligned with current recommendations with the exception of use of benzodiazepines.
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Source |
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8970594 | PMC |
http://dx.doi.org/10.3389/fped.2022.794722 | DOI Listing |
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