Pharmacoepidemiology and drug safety · 2026
Medication Growth Following Diagnosis of Intellectual and Developmental Disabilities at Varying Ages Throughout Childhood.
СтатьяНазвание и аннотация: Перевод в очереди
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Christian Robert B, Annis Izabela E, deJong Neal A, Davis Scott A, Hughes Phillip M, Thomas Kathleen C
Аннотация
PURPOSE: To characterize age-related trajectories in psychotropic medication and polypharmacy use among children newly diagnosed with intellectual and developmental disabilities (IDD), addressing an evidence gap in longitudinal prescribing patterns.
METHODS: This study uses a retrospective longitudinal cohort design and commercial insurance claims from the southeast (2011-2021) to study children newly diagnosed with IDD, aged 2-17 years (N = 938). Psychotropic medication use was defined as ≥ 1 prescription fill per year; polypharmacy as ≥ 2 classes used concurrently for ≥ 60 days. Generalized linear mixed models with natural cubic splines describe longitudinal growth trajectories as a function of age at first IDD diagnosis and follow-up year, adjusting for gender, cohort year and region of residence.
RESULTS: Within 3 years of diagnosis, 40.1% of children initiated psychotropic medication, and 9.4% experienced sustained polypharmacy. Medication use increased with each follow-up year among children diagnosed before age 12. For example, children diagnosed at age 2 had a 2.34-fold increase in medication use by year 3 versus year 1 (95% CI: 1.56-3.53) and nearly a sixfold increase in polypharmacy (OR = 5.89; 95% CI: 2.89-11.99). In contrast, children diagnosed during adolescence showed higher initial use but minimal growth. Psychiatric comorbidities also increased with time, particularly among younger children.
CONCLUSION: Children diagnosed with IDD at younger ages experience steep increases in psychotropic medication use over time, including sustained exposure to polypharmacy. Additional research on long-term benefits and harms of psychiatric medication use is needed.
METHODS: This study uses a retrospective longitudinal cohort design and commercial insurance claims from the southeast (2011-2021) to study children newly diagnosed with IDD, aged 2-17 years (N = 938). Psychotropic medication use was defined as ≥ 1 prescription fill per year; polypharmacy as ≥ 2 classes used concurrently for ≥ 60 days. Generalized linear mixed models with natural cubic splines describe longitudinal growth trajectories as a function of age at first IDD diagnosis and follow-up year, adjusting for gender, cohort year and region of residence.
RESULTS: Within 3 years of diagnosis, 40.1% of children initiated psychotropic medication, and 9.4% experienced sustained polypharmacy. Medication use increased with each follow-up year among children diagnosed before age 12. For example, children diagnosed at age 2 had a 2.34-fold increase in medication use by year 3 versus year 1 (95% CI: 1.56-3.53) and nearly a sixfold increase in polypharmacy (OR = 5.89; 95% CI: 2.89-11.99). In contrast, children diagnosed during adolescence showed higher initial use but minimal growth. Psychiatric comorbidities also increased with time, particularly among younger children.
CONCLUSION: Children diagnosed with IDD at younger ages experience steep increases in psychotropic medication use over time, including sustained exposure to polypharmacy. Additional research on long-term benefits and harms of psychiatric medication use is needed.