This research project is in progress. PCORI will post its findings here within 90 days after our final review is complete. In the meantime, results have been published in peer-reviewed journals, as listed below.
What is the research about?
Children in foster care are more likely than other children to take medicines that affect mood and behavior. Antipsychotics treat conditions such as schizophrenia and bipolar disorder. But these medicines are often used to treat more common behavior problems, such as attention deficit hyperactivity disorder. The medicines have serious long-term health risks, such as weight gain, heart attack, and diabetes.
States have different rules about how doctors prescribe these medicines to children in foster care. Researchers want to know how different policies affect how and when children in foster care get antipsychotics. They also want to know whether different policies affect children’s health and the health care they get.
Who can this research help?
Results of this study can help state policy makers develop and choose policies about how to treat behavioral problems in children in foster care and about how and when antipsychotics are appropriate as a treatment.
What is the research team doing?
The research team is comparing programs in four states—Ohio, Texas, Washington, and Wisconsin—to monitor how children in foster care are treated with medicines that affect mood and behavior. In each state, the research team is looking at records for all children in foster care. Depending on the state, the records are for a period of six to nine years, up to 2017. The records show what medicines children in foster care get, at what dose, and why. The research team wants to know how often children get more than one medicine, whether they get mental health evaluation and treatment as well, and how often the children go to the hospital. They also want to see whether medicine use is different in each state and whether it changes over time or when state laws change.
The research team is talking to adults who were in those states’ foster care systems as children, foster caregivers, social workers, doctors, and pharmacists to learn how each state’s policies affect those groups. People from those same groups are working with the research team to plan the study.
Research methods at a glance
|Population||Children in the foster care system who have been prescribed psychotropic medicines|
|Oversight systems in 4 states: Ohio, Texas, Washington, Wisconsin|
Antipsychotic use by age, polypharmacy, dosage, adherence, management of metabolic risks, mental health evaluation and services consistent with treatment, diagnosis consistent with treatment, hospitalization, emergency room use, self-harm events
|Analysis of data from 6- to 9-year period|
Evidence for Decisions
Antipsychotic Treatment for Children with Hyperactivity or Conduct Disorders
Clinicians often prescribe antipsychotics for children and adolescents diagnosed with attention deficit hyperactivity disorder (ADHD) or disruptive, impulse-control, and conduct disorders (DICDs). New evidence on the benefits and harms of this treatment can help with decisions about these drugs.
Other Clinical Interventions
Other Health Services Interventions
Training and Education Interventions