Abstract
Objective and Background
Little is known about pediatric psychotropic medication use in the emergency department
(ED), despite a rise in mental and behavioral health visits. This study describes
psychotropic medication use in a nationally representative sample of pediatric mental
and behavioral health ED visits over a 14-year period.
Methods
We conducted a cross-sectional analysis of pediatric (6–17 years) mental and behavioral
health ED visits using the National Hospital Ambulatory Medical Care Survey, 2006–2019.
We describe administration of psychotropic medications by medication type, diagnosis,
and over time. Using multivariable survey-weighted logistic regression, we examine
associations between medication administration and sociodemographics.
Results
A psychotropic medication was administered in 11.4% of the estimated 11,792,860 pediatric
mental and behavioral health ED visits in our sample. Benzodiazepines were administered
most frequently (4.9% of visits). Visits with anxiety disorders had the highest frequency
of psychotropic medication use (26.7%). Visits by Black non-Hispanic patients had
a 60% decreased odds of medication administration compared to visits for White non-Hispanic
patients. Visits with public compared to private insurance had a 3.5 times increased
odds of psychotropic polypharmacy. The proportion of visits in which a psychotropic
medication was administered did not change statistically over time.
Conclusions
A psychotropic medication was administered in 1 in 10 pediatric mental and behavioral
health ED visits. Use differed by sociodemographics but did not change over time.
As more youth seek mental and behavioral health care in the ED, we must better understand
appropriate medication use to ensure quality and equitable care.
Keywords
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Article info
Publication history
Published online: December 05, 2022
Accepted:
November 29,
2022
Received:
July 2,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
The authors have no conflicts of interest to disclose.
Identification
Copyright
Copyright © 2022 by Academic Pediatric Association
