Primary Care Clinician Perspectives on Medication Prescribing for Child Mental Health Concerns

Abstract

This study describes the frequency and comfort of pediatric primary care clinicians (PCCs) as it relates to initiating, continuing, and stopping medications for attention-deficit/hyperactivity disorder (ADHD), anxiety/depression, and sleep problems across age groups (≤5 years, 6-12, and 13+). Primary care clinicians (N = 148) within an integrated primary care national research consortium participated in an anonymous online survey including questions examining practice settings, provider characteristics, prescribing frequency, and prescribing comfort. Results indicate that comfort and prescribing practices vary by patient age, practice setting, provider experience, and presenting diagnoses. Primary care clinicians generally felt more comfortable prescribing for school-age children and older and prescribing for ADHD-related concerns. Primary care clinicians appeared similarly comfortable starting, maintaining, and stopping medications. Rural PCCs reported greater comfort initiating and managing medication. Results highlight the need for ongoing training and support for PCCs in managing common childhood mental health conditions. Implications for establishing collaborative infrastructure support and team-based care are discussed.