Changes in Psychiatric Medication Use During the COVID-19 Pandemic in a Pediatric Long-Term Care Facility.

IF 1.5 4区 医学 Q2 PEDIATRICS Journal of child and adolescent psychopharmacology Pub Date : 2024-05-01 Epub Date: 2024-04-29 DOI:10.1089/cap.2023.0067
Corrie Harris, Mst Sharmin Akter Sumy, Yana B Feygin, Heather Huxol, Ademilola Tejuoso, Theresa Kluthe, Scott Bickel
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Abstract

Background: Coronavirus disease 2019 (COVID-19) caused a global pandemic that dramatically altered infection control procedures in long-term care facilities. Mental health decline among residents of geriatric facilities during the pandemic has been described (Ferro Uriguen et al., 2022). Our study aims to evaluate psychological effects of the pandemic on residents of a pediatric long-term care facility, a population comprised of medically complex children. To characterize this, we compared patterns of psychotropic medication use during the COVID-19 pandemic to those of the prepandemic period among residents of a 76-bed pediatric long-term care facility. Methods: We conducted a retrospective study of psychotropic medication use from January 2019 to August 2022 using de-identified monthly facility medication refill data. Linear multivariable regression models were used to estimate the level and trends in the monthly rates of medication refills per 10,000 bed days among resident children before and after the pandemic onset. Six classes of psychotropic medications were analyzed including antipsychotics, antidepressants and anxiety medications, trazodone, clonidine, mood stabilizers, and gabapentin. Results: The pandemic onset was associated with a significant increase in the monthly prescribing rates of antidepressant and anxiety medications (20.83; 95% CI, 3.96-37.71; p = 0.017), mood stabilizers (10.44; 95% CI, 5.79-15.09; p < 0.001), and trazodone (-27.66; 95% CI, -40.44 to 14.88; p < 0.001) above those expected by prepandemic trends. The trend in trazodone use changed significantly during the pandemic from decreasing prepandemic to increasing (2.21; 95% CI, 1.28-3.14; p < 0.001). Antidepressant, anxiety medication, and gabapentin use increased throughout the study. Antidepressant and anxiety medication use surged early in the pandemic, but then continued growth at their prior rates of use. Discussion: Increased use of antidepressant and anxiety medications and trazodone suggests a possible impact of the COVID-19 pandemic on rates of anxiety, depression, sleep disturbance, and agitation among children with severe intellectual and developmental disabilities living in long-term care.

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一家儿科长期护理机构在 COVID-19 大流行期间精神科药物使用的变化。
背景:2019 年冠状病毒病(COVID-19)在全球范围内引起大流行,极大地改变了长期护理机构的感染控制程序。大流行期间,老年护理机构居民的心理健康状况有所下降(Ferro Uriguen 等人,2022 年)。我们的研究旨在评估大流行对儿科长期护理机构居民(由病情复杂的儿童组成)的心理影响。为了描述这种影响,我们比较了在 COVID-19 大流行期间和大流行之前,一家拥有 76 张床位的儿科长期护理机构的居民使用精神药物的模式。研究方法我们使用去标识化的每月设施药物补充数据,对 2019 年 1 月至 2022 年 8 月期间精神药物的使用情况进行了回顾性研究。我们使用线性多元回归模型来估算大流行爆发前后住院儿童每 10,000 个床位日的每月药物补充率的水平和趋势。分析了六类精神药物,包括抗精神病药、抗抑郁药和抗焦虑药、曲唑酮、氯尼丁、情绪稳定剂和加巴喷丁。研究结果大流行开始时,抗抑郁和焦虑药物(20.83;95% CI,3.96-37.71;p = 0.017)、情绪稳定剂(10.44;95% CI,5.79-15.09;p <0.001)和曲唑酮(-27.66;95% CI,-40.44-14.88;p <0.001)的每月处方率显著高于大流行前的预期。曲唑酮的使用趋势在大流行期间发生了显著变化,从大流行前的减少变为增加(2.21;95% CI,1.28-3.14;p <0.001)。在整个研究过程中,抗抑郁药、抗焦虑药和加巴喷丁的使用都有所增加。抗抑郁药和抗焦虑药的使用量在大流行初期激增,但随后以之前的使用率继续增长。讨论抗抑郁和焦虑药物以及曲唑酮使用量的增加表明,COVID-19 大流行可能会对长期护理的严重智力和发育障碍儿童的焦虑、抑郁、睡眠障碍和躁动率产生影响。
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来源期刊
CiteScore
3.60
自引率
5.30%
发文量
61
审稿时长
>12 weeks
期刊介绍: Journal of Child and Adolescent Psychopharmacology (JCAP) is the premier peer-reviewed journal covering the clinical aspects of treating this patient population with psychotropic medications including side effects and interactions, standard doses, and research on new and existing medications. The Journal includes information on related areas of medical sciences such as advances in developmental pharmacokinetics, developmental neuroscience, metabolism, nutrition, molecular genetics, and more. Journal of Child and Adolescent Psychopharmacology coverage includes: New drugs and treatment strategies including the use of psycho-stimulants, selective serotonin reuptake inhibitors, mood stabilizers, and atypical antipsychotics New developments in the diagnosis and treatment of ADHD, anxiety disorders, schizophrenia, autism spectrum disorders, bipolar disorder, eating disorders, along with other disorders Reports of common and rare Treatment Emergent Adverse Events (TEAEs) including: hyperprolactinemia, galactorrhea, weight gain/loss, metabolic syndrome, dyslipidemia, switching phenomena, sudden death, and the potential increase of suicide. Outcomes research.
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