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Safeguarding foster care youth from overmedication

Published online by Cambridge University Press:  23 March 2020

C. Pataki ,
C. Thompson ,
G. Crecelius ,
J. Tesoro ,
G. Polsky  and
P. Kambam
C. Pataki*
Affiliation:
David Geffen School of Medicine at UCLA, Psychiatry & Biobehavioral Science, Los Angeles, CA, USA Los Angeles County Department of Mental Health, Juvenile Court Mental Health Service, Monterey Park, CA, USA
C. Thompson
Affiliation:
David Geffen School of Medicine at UCLA, Psychiatry & Biobehavioral Science, Los Angeles, CA, USA Los Angeles County Department of Mental Health, Juvenile Justice Mental Health Program, Los Angeles, CA, USA
G. Crecelius
Affiliation:
Los Angeles County Department of Mental Health, Juvenile Court Mental Health Service, Monterey Park, CA, USA
J. Tesoro
Affiliation:
Los Angeles County Department of Mental Health, Juvenile Court Mental Health Service, Monterey Park, CA, USA University of Southern California School of Pharmacy, Pharmacy, Los Angeles, CA, USA
G. Polsky
Affiliation:
Los Angeles County Department of Mental Health, Juvenile Court Mental Health Service, Monterey Park, CA, USA
P. Kambam
Affiliation:
Los Angeles County Department of Mental Health, Juvenile Court Mental Health Service, Monterey Park, CA, USA
*
* Corresponding author.

Abstract

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Introduction

There are increasing concerns regarding long-term psychotropic polypharmacy prescribed for foster care youth 3.5 to 5 times more often than in at-home youth (Kreider et al., 2014). Polypharmacy risks include weight gain, glucose intolerance and type 2 diabetes. (De Hert et al., 2011). In view of these risks, novel interventions are essential to safeguard foster care youth from overmedication.

Objectives

To present guidelines for identification and management of polypharmacy in foster care youth.

Aims

To demonstrate a novel intervention to monitor and diminish polypharmacy and enhance psychiatric care in foster care children.

Methods

Polypharmacy is identified using LA County Juvenile Court Mental Health Service (JCMHS) Psychotropic Parameters* to review medication consent forms from treating psychiatrists. Polypharmacy triggers an in-person JCHMS consultation. *(Parameters 3.9 for JCMHS PMAF Review, Revised May 2015).

JCMHS Psychotropic Parameters (summary):

  • – age 0–5 years:

  • – 2 or > psychotropic medications,

  • – Any antipsychotic (*except Risperidone in ASD);

  • – age 6–8 years:

  • – 3 or > psychotropic medications;

  • – age 9–17 years:

  • – 4 or > psychotropic medications;

  • – All age youth:

  • – 2 or > psychotropic medications in the same class (antipsychotics, antidepressants, stimulants, mood stabilizers, alpha agonists).

Psychotropic medication doses in excess of recommended (*LA County Department of Mental Health Parameters 3.8 for use of Psychotropic Medications for Children and Adolescents).

Results

Approximately 25% of JCMHS annual psychiatric consultations were initiated by JCMHS parameters for polypharmacy. Corresponding consultations included education and recommendations discussed with treating psychiatrists regarding polypharmacy and optimal psychiatric management.

Conclusions

JCMHS Psychotropic Parameters is a useful tool to identify polypharmacy and enhance psychiatric care of foster care youth.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Type
EW86
Information
European Psychiatry , Volume 33 , Issue S1: Abstracts of the 24th European Congress of Psychiatry , March 2016 , pp. S133 - S134
Copyright
Copyright © European Psychiatric Association 2016
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