First-line Behavioral Health Treatment Prior to Stimulant or Alpha-2 Agonist Use for Preschoolers on Kentucky Medicaid in 2017

Author:

Davis Deborah Winders12ORCID,Jawad Kahir2,Lohr William David345,Trace Marie6,Le Jennifer34,Feygin Yana2,Jones Veronnie Faye1

Affiliation:

1. University of Louisville School of Medicine, KY, USA

2. Norton Children’s Research Institute affiliated with the University of Louisville School of Medicine, KY, USA

3. University of Louisville, KY, USA

4. Norton Children’s Medical Group, Louisville, KY, USA

5. Kentucky Department of Community Based Services, Frankfort, USA

6. Cleveland Clinic Children’s Hospital, OH, USA

Abstract

Objective: We aimed to assess the degree to which the American Academy of Pediatrics’ (AAP) clinical guidelines were followed when treating attention deficit/hyperactivity disorder (ADHD) in preschoolers. Method: Using Medicaid claims for children 4 to 5 years of age receiving their first dose of stimulants/alpha-2 agonists in 2017 ( n = 836), we determined if BH was received prior to initiation of medication. We examined predictors after controlling for confounders. Results: More than half the sample did not receive first-line BH, which did not differ by demographics. Those receiving BH prior to medication had a higher rate of receiving an ADHD diagnosis. Only three diagnoses were significant in multivariate (OR 13.8, 95% CI [1.7–115.1]) analyses. Conclusion: More than half the sample did not, conservatively, meet the AAP clinical recommendations. Further research is needed to identify targets for intervention. Limitations are noted.

Funder

Kentucky Cabinet for Health and Family Services

Publisher

SAGE Publications

Subject

Clinical Psychology,Developmental and Educational Psychology

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