First-line Behavioral Health Treatment Prior to Stimulant or Alpha-2 Agonist Use for Preschoolers on Kentucky Medicaid in 2017

Deborah Winders Davis, Kahir Jawad, William David Lohr, Marie Trace, Jennifer Le, Yana Feygin, Veronnie Faye Jones

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: We aimed to assess the degree to which the American Academy of Pediatrics’ (AAP) clinical guidelines were followed when treating attention deficit/hyperactivity disorder (ADHD) in preschoolers. Method: Using Medicaid claims for children 4 to 5 years of age receiving their first dose of stimulants/alpha-2 agonists in 2017 (n = 836), we determined if BH was received prior to initiation of medication. We examined predictors after controlling for confounders. Results: More than half the sample did not receive first-line BH, which did not differ by demographics. Those receiving BH prior to medication had a higher rate of receiving an ADHD diagnosis. Only three diagnoses were significant in multivariate (OR 13.8, 95% CI [1.7–115.1]) analyses. Conclusion: More than half the sample did not, conservatively, meet the AAP clinical recommendations. Further research is needed to identify targets for intervention. Limitations are noted.

Original languageEnglish
Pages (from-to)437-446
Number of pages10
JournalJournal of Attention Disorders
Volume27
Issue number4
DOIs
StatePublished - Feb 2023

Bibliographical note

Publisher Copyright:
© The Author(s) 2023.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The study was funded, in part, by a State-University Partnership with Kentucky Medicaid. The study sponsor had no involvement in the (1) study design; (2) the collection, analysis, and interpretation of data; (3) the writing of the report; or (4) the decision to submit the paper for publication.

FundersFunder number
Kentucky Department of Medicaid Services

    Keywords

    • attention deficit/hyperactivity disorder
    • children
    • low-income
    • psychotropic medication

    ASJC Scopus subject areas

    • Developmental and Educational Psychology
    • Clinical Psychology

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