P0054 - Prescribing Psychotropic Medications in Primary Care: Pediatric Resident Perspectives on Training and Practice

Objective: Pediatricians often function as front-line providers for pediatric behavioral health concerns given the shortage of child and adolescent psychiatrists and barriers to accessing other behavioral health specialists. This study identified pediatric residents’ attitudes, knowledge, comfort and practices regarding managing psychotropic medication regimens for children and adolescents with behavioral health concerns. Additionally, the study explored the effect that various psychotropic medication-related training processes had on prescribing attitudes, knowledge, comfort and practices.

Methods: Chief pediatric residents from pediatrics residency programs listed on the Association of American Medical Colleges’ Electronic Residency Application Service (ERAS®) website completed a 35-item survey inquiring about their attitudes, knowledge, comfort, practices, and training in managing psychotropic medication regimens. Data-elicitation involved multiple mail-based contacts and a noncontingent monetary incentive.

Results: The usable response rate was 60.2% (127/211). Roughly half of respondents reported being either Very or Somewhat Uncomfortable with prescribing psychotropic medications. The frequency in which respondents prescribe medications varied considerably (13.4% - Never, 38.6% - Rarely, 40.2% Sometimes, 7.9% - Often) and differed by condition type (anxiety, depression, ADHD, disruptive behaviors). Rank-order correlations revealed that frequency of prescribing was significantly positively related to knowledge (Kendall’s τ = .45, p < .001), comfort (τ = .40, p < .001), perceived competence in progress-monitoring (τ = .30, p < .001), and quality of training (τ = .41, p < .001).

Conclusion: Data suggested numerous barriers and facilitators to high-quality prescribing practices including training curricula, within-clinic support structures, and interprofessional collaboration. Training recommendations are discussed.