Kao-Ping Chua

New work from our members @ninahillmd.bsky.social @kaopingchua.bsky.social

More young adults than ever take HIV-prevention medication, but gaps remain Trends in use of pre-exposure prophylaxis, or PrEP, medication suggest more effort is needed to boost consistent use

With #HIV prevention medications (called PrEP for short) at the center of a #SCOTUS case that will receive a ruling soon, this new research from @ninahillmd.bsky.social & @kaopingchua.bsky.social is especially timely:
ihpi.umich.edu/news-events/...

New @journalgim.bsky.social: using national pharmacy data, we show that PrEP use is increasing among young people aged 18-25, but these patients are using PrEP for shorter periods of time. @kaopingchua.bsky.social @um-ihpi.bsky.social
link.springer.com/article/10.1...

New study in Pediatrics: using national data, we show that the Adderall shortage caused some children using this drug to switch to other stimulants. Other children stopped using stimulants altogether, especially Medicaid patients. @um-ihpi.bsky.social

publications.aap.org/pediatrics/a...

Medicaid Patients With ED Visits For Overdose: Disparities In Initiation Of Medications For Opioid Use Disorder | Health Affairs Journal Medications for opioid use disorder (MOUD) after emergency department (ED) visits for overdose can reduce subsequent overdose deaths, but disparities in receiving MOUD persist in the US. Using nationa...

People receiving emergency care for an opioid overdose have only a 1 in 16 chance of getting medication to treat substance use disorder in ER or the month after, according to this new study led by Thuy Nguyen of @umichsph.bsky.social & @kaopingchua.bsky.social: www.healthaffairs.org/doi/full/10....

New pub: using national data, we show that disruptions in chronic medication therapy were more common among Medicaid-insured kids and young adults living in states experiencing large Medicaid enrollment losses during Medicaid unwinding. @um-ihpi.bsky.social

publications.aap.org/pediatrics/a...

🧵By total coincidence, @kaopingchua.bsky.social & @jo-constantin.bsky.social have not one but TWO papers out today looking at the impacts of #Medicaid unwinding on the prescription-filling patterns of people with serious illness.

The findings could have implications for any new changes to Medicaid.

Medicaid unwinding disrupted kids’ and young adults’ access to chronic disease medicine Prescriptions for mental and behavioral health, epilepsy and asthma affected among those living in states with largest drops in Medicaid enrollment

Children and young adults taking drugs for #ADHD, #depression, #epilepsy, #asthma and #psychosis need to take them consistently to stay on track at school and work.

But a new study led by @kaopingchua.bsky.social links #Medicaid unwinding to medicine interruptions:
ihpi.umich.edu/news-events/...

New pub in JAMA: withdrawal of brand-name Flovent, an inhaled steroid used to prevent asthma attacks, led many families of children using Flovent to stop filling inhaled steroid prescriptions altogether. @um-ihpi.bsky.social
jamanetwork.com/journals/jam...

Yes, it is an important paper.

Today, I became the new Director of the Susan B Meister Child Health Evaluation and Research Center at the University of Michigan (chear.org). I am lucky to have the opportunity to give back to the center that has meant so much for my career. @um-ihpi.bsky.social

4/ Congrats to first author Joanne Constantin for this study.

3/ This is one of the first studies to evaluate the safety of telehealth stimulant prescribing. We hope it will inform ongoing debates about whether to extend telehealth flexibilities for controlled substance prescribing.

2/ In subgroup analyses, telehealth initiation was associated with higher risk of SUD in 26-34 year old even when controlling for mental health conditions. Thus, while telehealth initiation is not an independent risk factor for SUD in most people, it may be for this age group.

1/ New pub: people initiating stimulants via telehealth are more likely to develop a substance use disorder (SUD). They are also more likely to have mental health conditions (SUD risk factors). When controlling for these conditions, the association goes away. www.healthaffairs.org/doi/full/10....

Young people are increasingly using Wegovy and Ozempic A national study from Michigan Medicine shows that the use of these weight loss drugs is increasing rapidly in adolescents and young adults 12-25 years, especially females.

Alas @joyclee.bsky.social & @kaopingchua.bsky.social ‘s work documenting use of GLP-1 meds in teens and young adults was not mentioned so I’ll link it here: www.michiganmedicine.org/health-lab/y...

Trump casts psychiatric and weight-loss drugs as threats to children Trump directed a panel headed by HHS Secretary Robert F. Kennedy Jr. to assess “the prevalence of and threat” posed by SSRIs, mood stabilizers, stimulants, and weight-loss drugs.

New @washingtonpost.com story in which @kaopingchua.bsky.social’s work is cited/linked and a #Umich health insurance researcher is quoted: wapo.st/4hW2xGI

Mortality in the families of children during the COVID-19 pandemic: evidence from a repeated cross-sectional study of children in the United States - BMC Public Health Background Modeling studies suggest that hundreds of thousands of U.S. children have lost caregivers since the COVID-19 pandemic began. However, few studies have directly evaluated changes in mortalit...

New pub: using commercial claims, we show that mortality in the adult family members of children rose in winter 2020 and late 2021. Some of these family members were 19-25, suggesting kids lost older siblings during the pandemic. @norabeckermd.bsky.social
link.springer.com/article/10.1...

8/ Thanks to my center (Susan B. Meister Child Health Evaluation and Research Center; chear.org) for supporting our work.

7/ Findings suggest the shortage did not cause many children to stop stimulant therapy but may have prompted some to switch to alternative stimulants. Studies should evaluate whether these switches worsened control of ADHD symptoms or increased adverse events (e.g., from dosing errors).

6/ However, the announcement was associated with shifts in which stimulants were dispensed to children. Specifically, it was associated with declines in Adderall IR dispensing and increases in dispensing of other stimulants, such as lisdexamfetamine.

5/ The FDA announced a shortage of immediate-release mixed amphetamine salts (Adderall IR) in October 2022 (right vertical line). This announcement was not associated with a significant immediate change in the rate of dispensing of *any stimulant* to children.

4/ This is consistent with our study showing that antidepressant dispensing to male adolescents dropped abruptly in March 2020 but did not recover. Our findings raise concerns that undertreatment of mental health conditions in this group has increased.
publications.aap.org/pediatrics/a...

3/ While the stimulant dispensing rate recovered after March 2020 in most child subgroups, it remained persistently below the pre-pandemic baseline in male adolescents aged 12-17 years (blue line in graph below).

2/ We analyzed 2017-2023 data from a national all-payer prescription dispensing database. After March 2020 (left vertical line in the graph), the monthly stimulant dispensing rate decreased abruptly among all children.

1/ New pub in Pediatrics: the stimulant dispensing rate to U.S. children declined after the pandemic began. The Adderall shortage didn’t change this rate but likely caused children using Adderall to switch to other stimulants.

publications.aap.org/pediatrics/a...