“Polypharmacy Common Among Medicaid Youth With Behavioral Health Diagnoses”
MONDAY, Sept. 9, 2024 (HealthDay News) — A recent study published online on July 30 in BMC Primary Care reveals that contraindicated drug pairs are uncommon among youth with Medicaid coverage who are prescribed combinations of behavioral and mental health (BMH) medications.
Laura M. Borgelt, Pharm.D., from the University of Colorado Anschutz Medical Campus in Aurora, and colleagues conducted the study to explore the pharmaco-epidemiology of BMH medications in children, adolescents, and young adults, and to assess the prevalence of contraindicated drug pairs within this demographic. The analysis covered 2.4 million New York State Medicaid managed care and fee-for-service enrollees under the age of 21 in 2014.
The researchers discovered that 17.4 percent of the enrollees had at least one visit related to a BMH diagnosis, and 5.8 percent were prescribed one or more BMH medications. Polypharmacy was observed in 37.8 percent of individuals with a prescription, leading to 11,115 distinct drug combinations. Only 392 individuals were found to have filled a contraindicated pair of BMH medications for 30 days or more. These contraindicated pairs were associated with increased risks for prolonged QT interval and serotonin syndrome, affecting 378 and 250 patients respectively. Ziprasidone was notably involved in the majority of these combinations (3,247.1 per 10,000 ziprasidone prescriptions filled).
The authors noted that the prevalence of contraindicated drug pairs is low, suggesting that monitoring for such prescription patterns at the health maintenance organization level would be manageable and could identify a small number of genuine concerns, allowing for targeted reviews with prescribers.
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