Improved electronic communication could alleviate some of the over-prescribing, according to an opinion piece in the Sacramento Bee by Robert P. Holloway, MD, president of the California Academy of Child and Adolescent Psychiatry and an assistant professor of clinical psychiatry and behavioral sciences at University of Southern California’s Keck School of Medicine in Los Angeles. Many of the prescriptions for these children are paid for by Medicaid, and using psychotropic medications to treat children that have behavioral issues instead of providing them with mental health counseling creates a drain on the payment system, as well as damages the child, he wrote.
A recent Health Affairs blog post identified several potential causes for overprescription, including a lack of access to non-pharmaceutical treatments for behavioral difficulties, an inadequate supply of child behavioral health specialists in the area, limited clinical knowledge among child welfare case workers about appropriate medication use, aggressive pharmaceutical marketing and a lack of coordination across providers and child-serving agencies.
The blog post called for a number of corrections, including an aggregation of data across the healthcare delivery system that would determine appropriate baselines and outline prescription patterns. Dr. Holloway agreed with this, calling for physicians to have better access to EHR data and communication to coordinate care as well as setting priority on mental health treatment before prescribing psychotropic medication, he wrote.
“If we’re going to reduce prescribing, let’s do it the right way by giving kids and their families the support they need so they don’t reach the point of needing prescriptions in the first place,” Dr. Holloway wrote. “At the same time, when they need a prescription, let’s provide better support and communication, not further restrictions.”
