Antipsychotic Use Patterns in Medicaid-insured Youth in California: Variations by Region and Race/et

Monday, April 7, 2014
2:30 p.m.-3:30 p.m.
FDA-White Oak Bldg. 2, Room 2031
Ann Anonsen

View recording of this lecture.


Julie M. Zito, PhD
Professor Pharmaceutical Health Services Research
University of Maryland Baltimore


Despite widespread increased use of antipsychotic medications for the treatment of youth since the late ‘90s, little is known about the region of residence and its relationship to race/ethnicity. The objective of this study was to assess the impact of region of residence on racial/ethnic differences in the use of atypical antipsychotics among continuously enrolled youth in California Medicaid in 2009. A cross-sectional design was applied to computerized administrative claims data for 2,324,722 continuously enrolled California Medicaid beneficiaries aged 2 to 18 years.  Bivariate and multivariable analyses were used to assess differences in the utilization of atypical antipsychotic medications across the six large regions of the state. Regional percent prevalence of youth with one or more atypical antipsychotic dispensings during the year was further characterized by demographic and administrative factors. Multivariable findings were adjusted for age group, race/ethnicity, gender, Medicaid eligibility status and diagnostic group and expressed as odds ratios.  Additional models were used to assess racial/ethnic differences in antipsychotic use within each of the 6 regions.

Pronounced variations in ATP use for youths were identified by region in the state of CA (AOR range: 1.2-2.0). However, when race/ethnicity differences were examined separately for each region, compared with white youth, Hispanic youth had far fewer ATP dispensings, regardless of the region of residence (AOR range for Hispanic youth by regions: 0.3-0.4) indicating 60%-70% lower use than white youths in any region.


Julie Magno Zito is Professor of Pharmacy and Psychiatry at the University of Maryland, Baltimore. Her education includes a pharmacy degree, masters of Pharmaceutical Sciences and PhD in Social Pharmacy with a minor in Epidemiology. She is trained in pharmacoepidemiology and has more than 100 papers dealing with the use of psychotropic medications in community-treated populations. Her research focusing on medications for emotional and behavioral treatments of children and adolescents has received widespread media attention. She has received more than 4 million dollars in foundation or federally funded support (NIMH and NICHD), and most recently serves as a CERSI-research mentor to Dinci Pennap, a PhD student in the Department of Pharmaceutical Health Services Research.

Prior to coming to the University of Maryland, Dr. Zito was employed by the New York State Office of Mental Health at the Nathan Kline Institute where she authored a 1994 textbook of Psychotherapeutic Drug Monitoring for managing severe mental disorders. For the past 25 years, she has been active in the leadership of the Medical Care section of the American Public Health Association (APHA). At the international level, her work has been featured through collaborative studies of medication use in US and European samples and through visiting professorships in the Netherlands and Germany. In 2008, Zito was the first recipient from the School of Pharmacy to receive a University System of Maryland Regents’ Faculty Award for Research, Scholarship or Creative Activity.


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