Friday, January 26, 2024

More Than Half of New Stimulant Prescriptions at Pandemic’s Height Delivered Via Telemedicine

More than half of all first prescriptions for stimulant medications during the height of the COVID-19 pandemic were initiated via telemedicine, a study in Psychiatric Services has found. The study also suggests that telemedicine was more commonly used by psychiatrists than other health care providers and was associated with greater odds of receiving follow-up care.

Haiden A. Huskamp, Ph.D., of Harvard Medical School and colleagues analyzed data on commercially insured individuals recorded in the Optum Labs Data Warehouse from January 2019 through April 2022. The study used data from 535,629 children aged 2 to 17 years and 2,116,160 adults aged 18 to 64 years.

The percentage of adults who received their first prescription for stimulants (stimulant initiation) via telemedicine peaked at 52.7% in April 2020, then dropped to 27.9% by April 2022. The percentage of children who received their stimulant initiation via telemedicine peaked at 56.8% in April 2020, then dropped to 13.9% by April 2022.

Psychiatrists used telemedicine for 55.3% of their stimulant initiations for adults, whereas nonpsychiatrists used telemedicine for only 26.6% of their stimulant initiations for adults. Psychiatrists used telemedicine for 48.6% of their stimulant initiations for children, whereas nonpsychiatrists used telemedicine for only 17.5% of their stimulant initiations for children.

“Telemedicine initiation offered a way for adults and children to access ADHD [attention-deficit/hyperactivity disorder] treatment early in the pandemic when many clinics closed or curtailed in-person visits, and telemedicine may have helped reduce barriers to accessing care even after in-person visits became an option again,” Huskamp and colleagues wrote. They added that the drop in telemedicine use for stimulant initiations by 2022 was “not surprising” because many stimulant initiations are conducted by primary care physicians, who rapidly returned to providing in-person care.

For each month from January 2019 to April 2022, on average only 21.8% of stimulant initiations for adults and 26.6% of stimulant initiations for children were followed up with a visit with the prescribing health professional within 30 days. Patients were more likely to have a follow-up visit if they received stimulant initiation via telemedicine, received stimulant initiation from a psychiatrist, or had a co-occurring diagnosis other than ADHD.

“Future research is needed to understand the extent to which [the] patterns of stimulant initiation and follow-up care [that have been] observed since the onset of the pandemic represent high-quality care,” Huskamp and colleagues concluded.

For related information, see the Psychiatric News AlertNew Stimulant Prescriptions for ADHD Climbed During Pandemic, Study Shows.”

(Image: Getty Images/iStock/smartstock)

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