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Psychotherapy rates for children using ADHD drugs vary by location
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Recent data show receipt of psychotherapy among children who use attention-deficit/hyperactivity disorder medication varied geographically, regardless of psychologist supply in some cases.
Researchers assessed receipt of at least one outpatient therapy visit in 2010 among 301,530 children receiving ADHD medication from 1,516 US counties. Therapy visits were individual, group or family visits. The mean age of the children was 11.6 years. Researchers evaluated receipt of therapy by county and how it varied across counties based on the supply of licensed psychologists by quintile.
Overall, 24.5% of children receiving ADHD medication had at least one therapy visit in 2010. Unadjusted rates varied significantly across counties, from 6.3% in the 5th percentile of counties to 38.1% in the 95th percentile of counties. Adjusted analysis indicated 22.2% of children received therapy in the median county.
Thirteen percent of children had at least four therapy visits and 7.1% had at least eight visits. These rates varied significantly across counties, according to researchers.
Despite a comparable supply of psychologists, the proportion of children receiving therapy in Sacramento County, Calif., was more than twice as high as the proportion in Miami-Dade County, Fla., 47.8% vs. 19.9%. Sacramento County had a rate of 0.32 psychologists per 1,000 residents vs. 0.3 per 1,000 residents in Miami-Dade County.
“While medication-only treatment is consistent with guidelines for school-aged children, it may not represent the optimal treatment for many patients,” the researchers wrote. “The geographic variation in receipt of therapy, despite adjustment for clinical characteristics, may be explained not only by psychologist supply but also by parent, child, or pediatrician preferences for or comfort with nonpharmacologic care.”
Disclosure: Two researchers report financial ties with Express Scripts.
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