Characteristics of Primary Care Providers' Consultations with a Statewide Child Psychiatry Access Program Regarding Autism Spectrum Disorder.
- 2022
CONCLUSIONS: ASD patients for whom PCPs sought MD-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 PCPs treating ASD patients. Copyright (c) 2022. Published by Elsevier Inc. METHODS: We examined N= 3,641 MD-CPAP consultations from 2012 to 2019; n=311 were consultations for ASD. Demographics, treatment recommendations, diagnoses, and Clinical Global Impression-Severity (CGI-S) scores were collected. Patients who received psychotropic medication or psychotherapy by a MH provider were defined as co-managed. Descriptives and logistic regression were conducted. Sample for regression was N=1,854. OBJECTIVES: 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). We examined differences in illness severity, co-morbidity, and psychotropic medication use between patients with and without ASD for whom PCPs sought consultation from Maryland's (MD)-CPAP. RESULTS: Compared to non-ASD, consults regarding ASD patients were more often male (p<.001), aged 0-5 years (p<.001), severely ill (CGI-S> 4) (p<.001), and prescribed stimulants, non-stimulant ADHD medications, and antipsychotics (p<.001). Controlling for key covariates, consultations about youth: displaying aggression were 3.02 times (p<.001) more likely, with CGI-S>4 were 2.36 times (p<.001) more likely, and prescribed antipsychotics were 4.30 times more likely to concern an ASD patient (p<.001). A larger proportion of ASD patients (vs non-ASD) had co-morbid psychiatric diagnoses of ADHD, a Learning Disability, Disruptive Behavior Disorder vs. a smaller proportion with Major Depressive Disorder.