Trends in prescription of psychotropic medications to children and adolescents in Australian primary care from 2011 to 2018

2021 ◽  
pp. 000486742110677
Author(s):  
Julie Klau ◽  
Carla De Oliveira Bernardo ◽  
David Alejandro Gonzalez-Chica ◽  
Melissa Raven ◽  
Jon Jureidini
Keyword(s):  
Primary Care ◽  
Attention Deficit Hyperactivity Disorder ◽  
General Practitioner ◽  
Confidence Interval ◽  
Children And Adolescents ◽  
Attention Deficit ◽  
Psychotropic Medications ◽  
Annual Increase ◽  
Hyperactivity Disorder ◽  
Number Of Patients

Objective: To examine trends in prescribing psychotropic medications to children and adolescents in Australian primary care from 2011 to 2018. Method: A retrospective cohort study examined prescriptions written by general practitioners using MedicineInsight, a large Australian primary care database, covering approximately 9% of all general practitioner practices. Numbers of patients receiving prescriptions for five main classes of psychotropics (antipsychotics, antidepressants, attention deficit hyperactivity disorder medications, anxiolytics, and hypnotics/sedatives [including benzodiazepines and Z-drugs, but excluding melatonin]) were examined annually by age-group (0–4, 5–9, 10–14, 15–18 years). Melatonin was analysed separately. Results: The number of patients prescribed any psychotropic increased from 25.6 to 36.2 per 1000 individuals from 2011 to 2018 (average annual increase +4.5%, 95% confidence interval [4.1%, 4.9%]; overall +41.4%). Among the five main classes, the largest annual increase was for attention deficit hyperactivity disorder medications (+9.6%, 95% confidence interval [8.8%, 10.5%]; overall +95.8%), followed by antipsychotics (+6.2%, 95% confidence interval [5.0%, 7.3%]; overall +62.8%) and antidepressants (+4.5%, 95% confidence interval [4.0%, 5.0%]; overall +42.8%). Hypnotic/sedative prescribing decreased on average 6.5% per year (95% confidence interval [–8.0%, –5.0%]; overall −40.2%). Anxiolytic prescribing remained steady. Melatonin prescriptions showed the highest increase of all (+24.7%, 95% confidence interval [23.7%, 25.8%]; overall +606.7%). The largest annual increase in antipsychotic, antidepressant or attention deficit hyperactivity disorder medication prescribing occurred in 10- to 14-year-olds (+7.5%, +6.5% and +10.4%, respectively). The largest point prevalence occurred in 2018 among 15- to 18-year-olds, with 98.5 per 1000 prescribed antidepressants. Antidepressants were more frequently prescribed to females; antipsychotics, attention deficit hyperactivity disorder medications and melatonin more often to males. The most prescribed antipsychotics were risperidone (<15 years) and quetiapine (15- to 18-year-olds). Fluoxetine was the most prescribed antidepressant in those aged 5+ years and amitriptyline in 0- to 4-year-olds. Conclusion: General practitioner prescribing of melatonin, antipsychotics, antidepressants and attention deficit hyperactivity disorder medications to under-19-year-olds increased markedly from 2011 to 2018. Although benzodiazepine and Z-drug prescriptions declined, this was offset by a substantial increase in melatonin prescribing.

Age-related pharmacotherapy of attention deficit hyperactivity disorder in Slovenia in children and adolescents: A population-based study

2017 ◽  
Vol 42 ◽  
pp. 129-133 ◽  
Author(s):  
M. Stuhec ◽  
I. Locatelli
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Children And Adolescents ◽  
Prescription Drugs ◽  
Attention Deficit ◽  
Age Groups ◽  
Age Group ◽  
Hyperactivity Disorder ◽  
Age Related ◽  
Number Of Patients ◽  
Health Claims Data

AbstractBackgroundThere are no data on age-related pharmacotherapy for Attention Deficit Hyperactivity Disorder (ADHD) medication in children and adolescents in the most European countries. The main aim of this paper was to obtain that data for children and adolescents in Slovenia.MethodThe number of ADHD drug prescriptions per patient was obtained from the health claims data on prescription drugs of the Health Insurance Institute of Slovenia for the study period (2003–2015). Three age groups were analyzed: 2–5 years, 6–12 years, and 13–17 years. Only immediate-release methylphenidate (IR-MPH), methylphenidate-osmotic release oral delivery system (OROS-MPH), and atomoxetine (ATX) were available and included in this study.ResultsLess than 50% of patients in Slovenia were treated with medication. The number of patients treated with MPH in the 6–12 age group remained approximately the same between 2007 and 2015 (604–729 patients). In the 13–17 age group, however that number increased 2-fold between 2003 and 2015, from 288 to 555. The number of patients treated with ATX in the 6–12 age group age group increased from 20 to 163 between 2007 and 2015. The number was similar in the 13–17 age group, increasing from 10 to 165 in the same period. In 2015, 21% of the patients from all age groups in this study were treated with ATX.ConclusionsThe number of patients treated for ADHD increased rapidly in all age groups. Patients under the age of six are prescribed medication in Slovenia, which should be avoided.

Repeat Concussion and Recovery Time in a Primary Care Pediatric Office

2016 ◽  
Vol 31 (14) ◽  
pp. 1607-1610 ◽  
Author(s):  
Bruce Taubman ◽  
Jennifer McHugh ◽  
Florence Rosen ◽  
Okan U. Elci
Keyword(s):  
Primary Care ◽  
Attention Deficit Hyperactivity Disorder ◽  
Confidence Interval ◽  
Attention Deficit ◽  
Attention Deficit Disorder ◽  
Recovery Time ◽  
Unexpected Finding ◽  
Hyperactivity Disorder ◽  
Primary Care Office

The authors enrolled 95 patients in a primary care office who presented with a concussion. Of these patients, 63% were sport concussions. The authors matched 90 of these patients to children in the authors’ practice presenting for sports physicals or regular check-ups in the following demographics: age, participating in a particular sport, having attention-deficit disorder/attention-deficit hyperactivity disorder, gender, and grade. The authors found the odds of recurrent concussions, in a primary care pediatric office, to be a ratio of 2.909 (95% confidence interval 1.228-7.287). Recovery time for repeat concussion versus an initial concussion was analyzed. Patients with a recurrent concussion after a year recovered an average of 12.0 days after injury versus 13.4 days for those with no previous concussion (NS). Patients with a recurrent concussion within a year recovered a mean of 6.27 (SD 1.29) days sooner than patients with no previous concussion ( P < .0001). This unexpected finding is preliminary, and the authors encourage further research.

scholarly journals Behavioral and Electrophysiological Correlates of Performance Monitoring and Development in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder

2020 ◽  
Vol 10 (2) ◽  
pp. 79 ◽  
Author(s):  
Yanni Liu ◽  
Gregory L. Hanna ◽  
Barbara S. Hanna ◽  
Haley E. Rough ◽  
Paul D. Arnold ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
Children And Adolescents ◽  
Attention Deficit ◽  
Child Behavior Checklist ◽  
Performance Monitoring ◽  
Longitudinal Design ◽  
Flanker Task ◽  
Developmental Trajectory ◽  
Time Variability ◽  
Hyperactivity Disorder

The pathophysiology of attention-deficit/hyperactivity disorder (ADHD) involves deficits in performance monitoring and adaptive adjustments. Yet, the developmental trajectory and underlying neural correlates of performance monitoring deficits in youth with ADHD remain poorly understood. To address the gap, this study recruited 77 children and adolescents with ADHD and 77 age- and gender-matched healthy controls (HC), ages 8–18 years, who performed an arrow flanker task during electroencephalogram recording. Compared to HC, participants with ADHD responded more slowly and showed larger reaction time variability (RTV) and reduced post-error slowing; they also exhibited reduced error-related negativity (ERN) and error positivity effects, and reduced N2 and P3 congruency effects. Age effects were observed across groups: with increasing age, participants responded faster, with less variability, and with increased post-error slowing. They also exhibited increased ERN effects and increased N2 and P3 congruency effects. Increased RTV and reduced P3 amplitude in incongruent trials were associated with increased ADHD Problems Scale scores on the Child Behavior Checklist across groups. The altered behavioral and ERP responses in ADHD are consistent with the pattern associated with younger age across groups. Further research with a longitudinal design may determine specific aspects of developmental alteration and deficits in ADHD during performance monitoring.

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