FIGURE 3 : Parent / Guardian Reported Frequency of Adverse Effects as a Result of Medication Delays Due to Prior Authorization Requirements
25 24
Number of Respondents Endorsing Adverse Events
20
15
10
5
0
20
11 11 10 10
14
9 9 9
3 3 2 2
1
7
Delay in Getting Medication |
Physical Side Effects
Financial Burden
Changes in Medication
Family Effects
|
Emergency Departmet Visit |
Behavioral Issues
Emotional Issues
Aggression
Home Effects
|
Behavioral Issues |
Emotional Issues |
Aggression |
Drop in Grades
Missed School
School Effects
|
Suspension / Expulsion |
Changes in Classroom Placement |
Individualized Education Plan ( IEP ) Changes |
Adverse Events delayed . Two of the respondents in the 14 + day category wrote in reporting a wait of more than one month as they were never able to obtain authorization and required a medication change . Five participants reported that they only received their medicine after paying out of pocket .
Approximately 65 % of respondents indicated adverse events ( n = 24 ) as a result of delays ( see Figure 3 ). The mean number of adverse events reported per participant was 5 ( Range 0-12 ; SD 3.42 ). Four respondents reported experiencing delays with no adverse effects . The most common reported adverse event after time delay was behavior problems for the child at home and at school . Respondents endorsing financial burden included paying out of pocket for prescriptions , gas for repeated trips to the pharmacy , and missed time at work trying to obtain the prescription . One respondent independently indicated they paid for the medicine out of pocket immediately due to expectation of adverse outcomes if delayed . Two additional respondents indicated they paid for their medication out of pocket but did not report having financial burden in the Adverse Effects section .
DISCUSSION
The adverse consequences of non-adherence to psychotropic medications for children and adolescents have been well documented . 13 , 14 , 15 Poor outcomes such as increased individual suffering and family burden , need for additional therapeutic interventions , and increase in healthcare costs are frequently noted . Increasing medication adherence is an important area for clinical research and policy change , which often assumes that adherence is a result of controllable or individual factors . 16 , 17 However , this study documents the adverse consequences as
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