Changes in Psychiatric Medication Use During the COVID-19 Pandemic in a Pediatric Long-Term Care Facility

Corrie Harris; Mst Sharmin Akter Sumy; Yana B Feygin; Heather Huxol; Ademilola Tejuoso; Theresa Kluthe; Scott Bickel

doi:10.1089/cap.2023.0067

Changes in Psychiatric Medication Use During the COVID-19 Pandemic in a Pediatric Long-Term Care Facility

J Child Adolesc Psychopharmacol. 2024 Apr 29. doi: 10.1089/cap.2023.0067. Online ahead of print.

Authors

Corrie Harris¹, Mst Sharmin Akter Sumy², Yana B Feygin³, Heather Huxol¹, Ademilola Tejuoso⁴, Theresa Kluthe³, Scott Bickel⁵

Affiliations

¹ Division of Pediatric Hospitalist Medicine, Norton Children's and University of Louisville School of Medicine, Louisville, Kentucky, USA.
² Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, Kentucky, USA.
³ Norton Children's Research Institute, University of Louisville School of Medicine, Louisville, Kentucky, USA.
⁴ University of Louisville School of Medicine, Louisville, Kentucky, USA.
⁵ Division of Pediatric Pulmonology, Allergy and Immunology, Norton Children's and University of Louisville School of Medicine, Louisville, Kentucky, USA.

PMID: 38682450
DOI: 10.1089/cap.2023.0067

Abstract

Background: Coronavirus disease 2019 (COVID-19) caused a global pandemic that dramatically altered infection control procedures in long-term care facilities. Mental health decline among residents of geriatric facilities during the pandemic has been described (Ferro Uriguen et al., 2022). Our study aims to evaluate psychological effects of the pandemic on residents of a pediatric long-term care facility, a population comprised of medically complex children. To characterize this, we compared patterns of psychotropic medication use during the COVID-19 pandemic to those of the prepandemic period among residents of a 76-bed pediatric long-term care facility. Methods: We conducted a retrospective study of psychotropic medication use from January 2019 to August 2022 using de-identified monthly facility medication refill data. Linear multivariable regression models were used to estimate the level and trends in the monthly rates of medication refills per 10,000 bed days among resident children before and after the pandemic onset. Six classes of psychotropic medications were analyzed including antipsychotics, antidepressants and anxiety medications, trazodone, clonidine, mood stabilizers, and gabapentin. Results: The pandemic onset was associated with a significant increase in the monthly prescribing rates of antidepressant and anxiety medications (20.83; 95% CI, 3.96-37.71; p = 0.017), mood stabilizers (10.44; 95% CI, 5.79-15.09; p < 0.001), and trazodone (-27.66; 95% CI, -40.44 to 14.88; p < 0.001) above those expected by prepandemic trends. The trend in trazodone use changed significantly during the pandemic from decreasing prepandemic to increasing (2.21; 95% CI, 1.28-3.14; p < 0.001). Antidepressant, anxiety medication, and gabapentin use increased throughout the study. Antidepressant and anxiety medication use surged early in the pandemic, but then continued growth at their prior rates of use. Discussion: Increased use of antidepressant and anxiety medications and trazodone suggests a possible impact of the COVID-19 pandemic on rates of anxiety, depression, sleep disturbance, and agitation among children with severe intellectual and developmental disabilities living in long-term care.

Keywords: COVID-19; mental health; pediatric long-term care; psychiatric medication use.