क्लिनिकल पीडियाट्रिक्स: ओपन एक्सेस
खुला एक्सेस

अमूर्त

Care of Pediatric Patients with Tic Disorders by Provider Type: An Observational Study

Karen Chen, Erik Lehman, Debra Byler, Ashutosh Kumar, Gayatra Mainali, Laura Duda*

Tic disorders are common conditions treated by different health care providers. Provider availability, patient and family preferences, and community resources may affect which providers see these patients. This retrospective study evaluates how provider type influences treatment patterns in the care of patients with tic disorders. It includes a series of patients (age<18) presenting to Penn State Health’s Movement Disorder Clinic between August 2008 and September 2019 who were assessed by either a pediatrician or pediatric neurologist and diagnosed with tic disorder or Tourette syndrome. Demographics, diagnoses, medications, referrals, and follow-up statuses were evaluated. Chi- square tests were performed to compare treatment patterns between pediatrician and pediatric neurologists. A total of 399 patients were evaluated, 121 by a pediatrician and 278 by a pediatric neurologist. Pediatric neurologists were more likely than the pediatrician to prescribe any medication for tics (21.58% vs. 9.09%, p=0.003), particularly clonidine (7.55% vs. 0.83%, p=0.007) and topiramate (8.63% vs. 1.65%, p=0.009). Pediatric neurologists were also more likely to schedule patients for follow-up (71.58% vs. 31.40%, p<0.001). In contrast, the pediatrician more frequently referred patients for cognitive behavioral therapy (52.07% vs. 2.52%, p<0.001) and comprehensive behavioral intervention for tics (26.45% vs. 7.55%, p<0.001). In this observational study, the pediatric neurologists prescribed more medications and followed up with patients more often, while the pediatrician tended to refer patients for behavioral interventions.