{"id":16487,"date":"2023-05-12T10:21:00","date_gmt":"2023-05-12T14:21:00","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=16487"},"modified":"2023-07-28T10:31:01","modified_gmt":"2023-07-28T14:31:01","slug":"adherence-to-antipsychotic-laboratory-monitoring-guidelines-in-children-and-youth","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/adherence-to-antipsychotic-laboratory-monitoring-guidelines-in-children-and-youth\/","title":{"rendered":"Adherence to antipsychotic laboratory monitoring guidelines in children and youth: a population-based study"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><strong>Background<\/strong> \u2014 In 2011, the Canadian Alliance for Monitoring Effectiveness and Safety of Antipsychotics in Children (CAMESA) published guidelines for the metabolic monitoring of antipsychotic-treated children and youth. Population-based studies examining adherence to these guidelines are needed to ensure the safe use of antipsychotics in children and youth.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Methods<\/strong> \u2014 We conducted a population-based study of all Ontario residents aged 0 to 24 who were newly dispensed an antipsychotic between April 1, 2018, and March 31, 2019. We estimated prevalence ratios (PRs) and 95% confidence intervals (CI) associating sociodemographic characteristics with the receipt of baseline and follow-up (3- and 6-month) laboratory testing using log-Poisson regression models.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Results<\/strong> \u2014 Overall, 6,505 of 27,718 (23.5%) children and youth newly dispensed an antipsychotic received at least one guideline-recommended baseline test. Monitoring was more prevalent among individuals aged 10 to 14 years (PR 1.20; 95% CI 1.04 to 1.38), 15 to 19 years (PR 1.60; 95% CI 1.41 to 1.82), and 20 to 24 years (PR 1.71; 95% CI 1.50 to 1.94) compared to children under the age of 10. Baseline monitoring was associated with mental health-related hospitalizations or emergency department visits in the year preceding therapy (PR 1.76; 95% CI 1.65 to 1.87), a prior diagnosis of schizophrenia (PR 1.20; 95% CI 1.14 to 1.26) or diabetes (PR 1.35; 95% CI 1.19 to 1.54), benzodiazepine use (PR 1.13; 95% CI 1.04 to 1.24), and receipt of a prescription from a child and adolescent psychiatrist or developmental pediatrician versus a family physician (PR 1.41; 95% CI 1.34 to 1.48). Conversely, monitoring was less frequent in individuals co-prescribed stimulants (PR 0.83; 95% CI 0.75 to 0.91). The prevalence of any 3- and 6-month follow-up monitoring among children and youth receiving continuous antipsychotic therapy at these time points was 13.0% (1,179 of 9,080) and 11.4% (597 of 5,261), respectively. Correlates of follow-up testing were similar to those of baseline monitoring.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Conclusion<\/strong> \u2014 Most children initiating antipsychotic therapy do not receive guideline-recommended metabolic laboratory monitoring. Further research is needed to understand reasons for poor guideline adherence and the role of clinician training and collaborative service models in promoting best monitoring practices.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Background \u2014 In 2011, the Canadian Alliance for Monitoring Effectiveness and Safety of Antipsychotics in Children (CAMESA) published guidelines for the metabolic monitoring of antipsychotic-treated children and youth. Population-based studies examining adherence to these guidelines are needed to ensure the safe use of antipsychotics in children and youth. Methods \u2014 We conducted a population-based study [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[16,62,34,56],"migration-helper-qa-sample-set":[],"class_list":["post-16487","journal_article","type-journal_article","status-publish","hentry","topic-children-and-young-people","topic-health-services-research","topic-mental-health-and-addictions","topic-pharmacoepidemiology-and-drug-safety"],"acf":{"citation":"Antoniou T, Wang T, Pajer K, Gardner W, Lunsky Y, Penner M, Tadrous M, Mamdani M, Juurlink DN, Gomes T. <em>Front Psychiatry<\/em>. 2023; 14:1172559. Epub 2023 May 12.","source_url":"https:\/\/doi.org\/10.3389\/fpsyt.2023.1172559","ices_scientist":[1282,1252,1386,1240,1296,1108,1325],"site":[6733],"research_program":[6746],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Adherence to antipsychotic laboratory monitoring guidelines in children and youth: a population-based study<\/title>\n<meta name=\"description\" content=\"Background \u2014 In 2011, the Canadian Alliance for Monitoring Effectiveness and Safety of Antipsychotics in Children (CAMESA) published guidelines for the\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link 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