Who is prescribing psychotropic medications in a public developmental-behavioural clinical service and how often?

J Paediatr Child Health. 2020 Apr;56(4):532-536. doi: 10.1111/jpc.14676. Epub 2019 Nov 13.

Abstract

Aim: Psychotropic prescribing by paediatricians is increasingly common, and there is considerable variation in care provided. The aims of this study were to examine current rates of psychotropic prescribing in the developmental-behavioural outpatient clinics at the Royal Children's Hospital's Centre for Community Child Health, and to compare rates between paediatric consultants and advanced trainees.

Methods: Data were extracted for appointment encounters from electronic medical records across 12 months in 2017. Patient demographics, provider and medication order data were analysed using Excel and STATA to calculate logistic regression, standard deviation, percentages and means.

Results: From 5069 encounters, there were 847 (16.7%) that included psychotropic prescribing. Advanced trainees prescribed psychotropic medications in only 4.4% of their encounters compared with consultants who prescribed these medications in 23% of encounters (P < 0.001). Stimulants were the most commonly prescribed psychotropic medication (62%), either alone (86.3%) or in combination (13.7%).

Conclusions: Psychotropic prescribing rates were lower than expected. Advanced trainees may need more experience in psychotropic prescribing.

Keywords: clinical competence; paediatrician; physician; practice pattern; psychotropic drug.

MeSH terms

  • Child
  • Humans
  • Pediatricians
  • Practice Patterns, Physicians'
  • Psychotropic Drugs* / therapeutic use
  • Work*

Substances

  • Psychotropic Drugs