TABLE 1.
Demographic and Clinical Characteristics of Patients Stratified by Receipt of Polypharmacy
| Characteristic | Multiple Prescribers Involved in Treatment (N = 8,092) | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| PCPs Only (n = 3,408; 42.1%) | Specialists Only (n = 1,921; 23.7%) | PCPs + Specialists (n = 2,763; 34.1%) | |||||||||
| No Polypharmacy (n = 3,000; 88.0%) | Psychotropic Polypharmacy (n = 408; 12.0%) | P Value | No Polypharmacy (n = 1,143; 59.5%) | Psychotropic Polypharmacy (n =778; 40.5%) | P Value | No Polypharmacy (n = 1,578; 57.1%) | Psychotropic Polypharmacy (n = 1,185; 42.9%) | P Value | |||
| Predisposing characteristics | |||||||||||
| Age group, years, n (%) | |||||||||||
| 0-3 | 43 (1.4) | 3 (0.7) | 8 (0.7) | 7 (0.9) | 10 (0.6) | 11 (0.9) | |||||
| 4-8 | 1,172 (39.1) | 176 (43.1) | 380 (33.3) | 216 (27.8) | 625 (39.6) | 452 (38.1) | |||||
| 9-12 | 1,182 (39.4) | 180 (44.1) | 344 (30.1) | 249 (32.0) | 516 (32.7) | 407 (34.4) | |||||
| 13-18 | 603 (20.1) | 49 (12.0) | 411 (36.0) | 306 (39.3) | 427 (27.1) | 315 (26.6) | |||||
| Mean (± SD)a | 9.62 ± 3.25 | 9.14 ± 2.78 | < 0.001 | 10.61 ± 3.66 | 10.92 ± 3.59 | 0.535 | 9.96 ± 3.55 | 9.88 ± 3.43 | 0.213 | ||
| Sex, n (%) | |||||||||||
| Male | 2,064 (68.8) | 303 (74.3) | 0.025 | 670 (58.7) | 465 (59.8) | 0.637 | 1,023 (64.8) | 781 (65.9) | 0.572 | ||
| Race/ethnicity, n (%) | |||||||||||
| African American | 621 (20.7) | 68 (16.7) | 0.057 | 286 (25.0) | 191 (24.6) | 0.829 | 406 (25.7) | 239 (20.2) | < 0.001 | ||
| Caucasian | 1,144 (38.1) | 227 (55.6) | < 0.010 | 239 (20.9) | 260 (33.4) | < 0.001 | 452 (28.6) | 584 (49.3) | < 0.001 | ||
| Hispanic | 1,095 (36.5) | 105 (25.7) | < 0.001 | 573 (50.1) | 297 (38.2) | < 0.001 | 672 (42.6) | 324 (27.3) | < 0.001 | ||
| Not reported | 140 (4.7) | 8 (2.0) | 0.068 | 45 (3.9) | 30 (3.9) | 0.878 | 48 (3.0) | 38 (3.2) | 0.896 | ||
| Enabling characteristics | |||||||||||
| Care density | |||||||||||
| Mean (± SD) | 25.40 ± 31.90 | 21.15 ± 24.32 | < 0.001 | 43.90 ± 79.66 | 29.72 ± 52.83 | 0.119 | 26.48 ± 51.86 | 44.43 ± 59.44 | < 0.001 | ||
| Median | 14.00 | 11.00 | < 0.001 | 9.00 | 7.42 | 0.278 | 3.58 | 11.50 | < 0.001 | ||
| Need characteristics | |||||||||||
| Number of mental/behavioral disorders diagnosed, n (%) | |||||||||||
| 0 | 47 (1.6) | 5 (1.2) | 1 (0.1) | 0 (0) | 14 (0.9) | 3 (0.3) | |||||
| 1 | 2,002 (66.7) | 172 (42.2) | 367 (32.1) | 118 (15.2) | 576 (36.5) | 306 (25.8) | |||||
| 2-4 | 922 (30.7) | 209 (51.2) | 686 (60.0) | 513 (65.9) | 897 (56.8) | 710 (59.9) | |||||
| ≥ 5 | 29 (1.0) | 22 (5.4) | 89 (7.8) | 147 (18.9) | 91 (5.8) | 166 (14.0) | |||||
| Mean (± SD) | 1.46 ± 0.84 | 2.06 ± 1.25 | < 0.001 | 2.37 ± 1.33 | 3.14 ± 1.59 | 0.894 | 2.18 ± 1.27 | 2.71 ± 1.60 | 0.043 | ||
| Type of mental/behavioral disorder diagnosed, n (%)a | |||||||||||
| ADHD | 2,731 (91.0) | 390 (95.6) | < 0.001 | 843 (73.8) | 588 (75.6) | 0.393 | 1,298 (82.3) | 1,031 (87.0) | < 0.001 | ||
| Bipolar disorders | 79 (2.6) | 32 (7.8) | < 0.001 | 325 (28.4) | 473 (60.8) | < 0.001 | 295 (18.7) | 481 (40.6) | < 0.001 | ||
| Depression | 156 (5.2) | 44 (10.8) | < 0.001 | 317 (27.7) | 291 (37.4) | < 0.001 | 330 (20.9) | 299 (25.2) | < 0.001 | ||
| Anxiety | 185 (6.2) | 63 (15.4) | < 0.001 | 214 (18.7) | 216 (27.8) | < 0.001 | 276 (17.5) | 253 (21.4) | 0.011 | ||
| Learning disorders | 308 (10.3) | 49 (12.0) | 0.301 | 126 (11.0) | 71 (9.1) | 0.193 | 190 (12.0) | 112 (9.5) | 0.031 | ||
| Adjustment disorders | 218 (7.3) | 37 (9.1) | 0.192 | 186 (16.3) | 144 (18.5) | 0.218 | 207 (13.1) | 192 (16.2) | 0.031 | ||
| Conduct disorder | 275 (9.2) | 53 (13.0) | 0.019 | 166 (14.5) | 134 (17.2) | 0.110 | 250 (15.8) | 190 (16.0) | 0.916 | ||
| Oppositional defiant disorder | 120 (4.0) | 75 (18.4) | < 0.001 | 219 (19.2) | 198 (25.5) | 0.001 | 296 (18.8) | 295 (24.9) | < 0.010 | ||
| Schizophrenia | 35 (1.2) | 17 (4.2) | < 0.001 | 86 (7.5) | 127 (16.3) | < 0.001 | 81 (5.1) | 117 (9.9) | < 0.010 | ||
| Number of prescribers involved in treatment, n (%) | |||||||||||
| 2-4 | 2,841 (94.7) | 376 (92.2) | 1,126 (98.5) | 732 (94.1) | 1,479 (93.7) | 978 (82.5) | |||||
| ≥ 5 | 159 (5.3) | 32 (7.8) | 17 (1.5) | 46 (5.9) | 99 (6.3) | 207 (17.5) | |||||
| Mean (± SD) | 2.59 ± 1.03 | 2.84 ± 1.38 | < 0.001 | 2.29 ± 0.63 | 2.67 ± 1.03 | < 0.001 | 2.73 ± 1.02 | 3.40 ± 1.34 | < 0.001 | ||
| Hospitalization/ED visit, n (%) | |||||||||||
| Yes | 238 (7.9) | 44 (10.8) | 0.050 | 297 (26.0) | 316 (40.6) | < 0.001 | 290 (18.4) | 350 (29.5) | < 0.001 | ||
aReported as frequency and percentage of patients who were diagnosed with the respective disorder in each group.
ADHD = attention-deficit/hyperactivity disorder; ED = emergency department; PCP = primary care practitioner; SD = standard deviation.