Texas program reduces prescription use in foster children without compromising care, Rutgers study finds

<p>The Rutgers study found that the Texas strategy effectively reduces the number of foster children who take antipsychotic drugs off-label for conditions such as hyperactivity disorders, while not decreasing use for disorders with FDA indications, such as bipolar disorder.</p>

The Rutgers study found that the Texas strategy effectively reduces the number of foster children who take antipsychotic drugs off-label for conditions such as hyperactivity disorders, while not decreasing use for disorders with FDA indications, such as bipolar disorder.


A recent Rutgers study has found that a strategy developed in Texas to reduce antipsychotic medication for children can act as a model for other state Medicaid programs, according to an article on Rutgers Today

The study was published in the Journal of the American Academy of Child and Adolescent Psychiatry, according to Rutgers Today.

“Youth in the United States foster care system are about five times more likely to take antipsychotic medications, a class of medications to manage their mental and behavioral health, than children in the general public,” said Thomas Mackie, assistant professor at Rutgers School of Public Health, according to Rutgers Today.

Over 31 state Medicaid programs nationally experiment with different oversight strategies in order to ensure safe use of antipsychotic medications, according to Rutgers Today. 

These programs face the challenge of addressing these concerns while also ensuring access to antipsychotic medications in cases where they are clinically optimal, according to Rutgers Today. These cases include youth with psychosis, autism and other U.S. Food and Drug Administration (FDA)-approved clinical indications.

The strategy implemented in Texas included four elements, such as a mental health screening given within 72 hours of the child being removed from the original caregiver and a psychiatric consultation line for child welfare staff, caregivers and judges, according to Rutgers Today. 

This study aimed to find whether the Texas program was effective in reducing the number of youth in foster care prescribed antipsychotic medications off-label for conditions such as attention hyperactivity disorders, while not decreasing use for disorders with FDA indications, such as bipolar disorder, according to Rutgers Today. 

Rutgers researchers found that this strategy resulted in approximately a 5 to 8 percent reduction in antipsychotic use for youth treated off-label for conditions like attention hyperactivity disorders. There were no significant changes found for youth treated for FDA-indicated conditions.

This study found that the Texas program has effectively reduced the use of antipsychotic medications for off-label conditions while not reducing antipsychotic medications for FDA-indicated conditions, according to Rutgers Today. 

“Although the Texas model enrolled only youths in foster care, similar innovations are increasingly being extended to the general population of Medicaid-insured youth,” Mackie said. “This study provides important new evidence suggesting that states continue to incorporate or renew the inclusion of these additional behavioral health services into Medicaid-managed care arrangements.”


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