Kao-Ping Chua

Kao-Ping Chua

@kaopingchua.bsky.social

Primary care pediatrician and health policy researcher at the University of Michigan studying the opioid epidemic, out-of-pocket spending, low-value care, child health. Director, CHEAR Center (chear.org). MD (Wash U), PhD (Harvard). Go Lions and Go Blue

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Kao-Ping Chua reposted

Kao-Ping Chua reposted

Kao-Ping Chua reposted

Children and young adults taking drugs for #ADHD, #depression, #epilepsy, #asthma and #psychosis need to take them consistently to stay on track at school and work. But a new study led by @kaopingchua.bsky.social links #Medicaid unwinding to medicine interruptions: ihpi.umich.edu/news-events/...

ihpi.umich.eduMedicaid unwinding disrupted kids’ and young adults’ access to chronic disease medicinePrescriptions for mental and behavioral health, epilepsy and asthma affected among those living in states with largest drops in Medicaid enrollment
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3/ This is one of the first studies to evaluate the safety of telehealth stimulant prescribing. We hope it will inform ongoing debates about whether to extend telehealth flexibilities for controlled substance prescribing.

2/ In subgroup analyses, telehealth initiation was associated with higher risk of SUD in 26-34 year old even when controlling for mental health conditions. Thus, while telehealth initiation is not an independent risk factor for SUD in most people, it may be for this age group.

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7/ Findings suggest the shortage did not cause many children to stop stimulant therapy but may have prompted some to switch to alternative stimulants. Studies should evaluate whether these switches worsened control of ADHD symptoms or increased adverse events (e.g., from dosing errors).

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5/ The FDA announced a shortage of immediate-release mixed amphetamine salts (Adderall IR) in October 2022 (right vertical line). This announcement was not associated with a significant immediate change in the rate of dispensing of *any stimulant* to children.

6/ However, the announcement was associated with shifts in which stimulants were dispensed to children. Specifically, it was associated with declines in Adderall IR dispensing and increases in dispensing of other stimulants, such as lisdexamfetamine.

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3/ While the stimulant dispensing rate recovered after March 2020 in most child subgroups, it remained persistently below the pre-pandemic baseline in male adolescents aged 12-17 years (blue line in graph below).

2/ We analyzed 2017-2023 data from a national all-payer prescription dispensing database. After March 2020 (left vertical line in the graph), the monthly stimulant dispensing rate decreased abruptly among all children.

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