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    Characteristics of Primary Care Providers' Consultations With a Statewide Child Psychiatry Access Program Regarding Autism Spectrum Disorder

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    Author
    Reinblatt, Shauna P.
    Coble, Kelly
    Williams, Jami Lin L.
    Cotton, Aronica M.
    Bettencourt, Amie F.
    Date
    2022-01-01
    Journal
    Journal of the Academy of Consultation-Liaison Psychiatry
    Publisher
    Elsevier
    Type
    Article
    
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    See at
    https://doi.org/10.1016/j.jaclp.2022.01.004
    Abstract
    Background: Child Psychiatry Access Programs (CPAPs) provide consultative support for pediatric primary care providers (PCPs) to treat co-morbid mental health (MH) symptoms among patients with Autism Spectrum Disorder (ASD). Objectives: We examined differences in illness severity, comorbidity, and psychotropic medication use between patients with and without ASD for whom primary care providers sought consultation from Maryland's CPAP. Methods: We examined N = 3641 Maryland's CPAP consultations from 2012 to 2019; n = 311 were consultations for ASD. Demographics, treatment recommendations, diagnoses, and Clinical Global Impression-Severity scores were collected. Patients who received psychotropic medication or psychotherapy by an mental health provider were defined as comanaged. Descriptives and logistic regression were conducted. Sample size for regression was N = 1854. Results: Compared with non-ASD, patients with consults for ASD were more often male (P < 0.001), aged 0–5 years (P < 0.001), severely ill (Clinical Global Impression-Severity > 4) (P < 0.001), and prescribed stimulants, nonstimulant attention-deficit hyperactivity disorder medications, and antipsychotics (P < 0.001). Controlling for key covariates, consultations for youth displaying aggression were 3.02 times (P < 0.001) more likely, with Clinical Global Impression-Severity > 4 were 2.36 times (P < 0.001) more likely, and prescribed antipsychotics were 4.30 times more likely to concern an ASD patient (P < 0.001). A larger proportion of ASD patients (vs. non-ASD) had comorbid psychiatric diagnoses of attention-deficit hyperactivity disorder, a learning disability, and disruptive behavior disorder vs. a smaller proportion with major depressive disorder. Conclusions: ASD patients for whom primary care providers sought Maryland's CPAP consultation were more severe and complex than non-ASD patients in terms of comorbid diagnoses and medication regimen. Findings suggest that consultations with CPAPs provide medication management support to pediatric primary care providers treating ASD patients. © 2022 The Authors
    Sponsors
    U.S. Department of Health and Human Services
    Keyword
    autism spectrum disorder
    child psychiatry access program
    collaborative mental health care
    pediatric mental health care
    psychiatric consultation
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/18569
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.jaclp.2022.01.004
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