K. Jariwala

Use and cost of psychotropic drugs among recipients with autism in a state Medicaid fee-for-service programme

BACKGROUND There has been a significant increase in the prevalence of autism in the USA in the past few decades. The purpose of this study was to provide recent estimates of psychotropic drug use and costs among individuals with autism enrolled in Medicaid programme. METHOD A cross-sectional analysis of 2007 Mississippi (MS) Medicaid fee-for-service (FFS) programme administrative-claims data was performed. Study sample included recipients (<65 years) who had a medical services claim with a diagnosis of autism in 2007. Psychotropic drug patterns of use and costs were studied. Factors predicting the use of psychotropic drugs were identified using logistic regression analyses. Average number and cost of psychotropic drug claims per recipient were reported. Costs were reported from the perspective of MS Medicaid. RESULTS In 2007, there were 1330 recipients with a diagnosis of autism in MS Medicaid FFS programme. Among these recipients, 66.32% had a claim for psychotropic drug during the year. Roughly 39% of recipients with autism had a claim for antipsychotics, 31.58% for stimulants, 19.55% for antidepressants, 19.40% for other psychotropics and 14.81% for anxiolytics/hypnotics/sedatives. Results from regression analyses highlighted variation in psychotropic drug use by demographic and co-morbid factors. There were a total of 12,618 claims for psychotropic drugs filled by recipients with autism in 2007, at an average of 14 (±12) claims per recipient. The total cost of these claims paid for by MS Medicaid FFS programme was ∼

Health Utility Assessment Using EQ-5D among Caregivers of Children with Autism

2 million. Antipsychotics accounted for more than half (∼58%) of the total costs, and had the highest average cost per claim (

Validity and reliability of the Medical Outcomes Study Short-Form Health Survey version 2 (SF-12v2) among adults with autism

291 ± 205). CONCLUSIONS The results of this study indicate a high use of psychotropic drugs among individuals with autism enrolled in a state Medicaid programme. There is an urgent need to study the risk-benefit profile of these drugs in this growing population. Psychotropic drug use was found to vary by demographic and co-morbid factors. Among the different classes of psychotropic drugs, antipsychotics were the most commonly used and had the highest cost per claim.

Adoption of and experience with e-prescribing by primary care physicians

OBJECTIVES Health utility of caregivers of children with autism was assessed by using the EuroQol five-dimensional (EQ-5D) questionnaire. Utility scores of autism caregivers were compared with norms for the general adult US population. Predictors of health utility were identified. METHODS A cross-sectional online survey design was used. Caregivers registered with the Interactive Autism Network were approached for participation in the online survey. Three hundred and sixteen usable responses were received. Health utility among caregivers was calculated and compared with the US population norms by using Students t test. Problems in EQ-5D questionnaire domains and utility scores were analyzed by study characteristics by using Kruskal-Wallis analysis of variance. Factors predicting health utility were identified by using ordinary least square regression. RESULTS Roughly 94% of the caregivers who participated in the study were females. As compared to their counterparts in the general US population, caregivers who were aged 18 to 44 years and were females had lower utility scores (P < 0.001). Significant differences in utility scores were observed among caregivers. When compared to males, females had lower health utility. Caregivers of lower socioeconomic status had lower utility scores and reported more problems in EQ-5D questionnaire domains than did those from higher socioeconomic status. Caregiver burden was inversely correlated with health utility. Caregiver physical and mental health status, objective strain, education, and relationship with the care recipient were found to significantly predict health utility (adjusted R(2) ~57%). CONCLUSIONS Autism caregivers had lower health utility than did the general adult US population. There is an immediate need to address health concerns among this growing population.

Awareness and knowledge of autism among pharmacists

BACKGROUND The purpose of the study was to assess the validity and reliability of the Medical Outcomes Study Short Form-12 version 2 (SF-12v2) instrument among adults with autism. METHODS Study data was collected using a cross-sectional online survey of adults with autism enrolled with the Interactive Autism Network (N=291). Factorial validity was assessed using confirmatory factor analysis technique. Item-scale correlations were examined for convergent validity. Known-groups validity was assessed by examining the variation in Physical Component Summary (PCS) and Mental Component Summary (MCS) scores by autism severity. Cronbachs alpha was determined for internal consistency reliability. Floor and ceiling effects were also assessed. RESULTS A two-factor model with correlated error terms was found to have a good fit. The PCS scale strongly correlated with the underlying items representing the scale. The MCS scale had strong to moderate correlation with its underlying items. For known-groups validity, the MCS score varied as expected with lower score observed among adults with high severity as compared to low severity; however, PCS score varied inversely. Internal consistent reliability of the SF-12v2 was good, and there were no floor and ceiling effects. CONCLUSIONS Except for known-groups validity, all other psychometric indicators performed well for the SF-12v2.