Prescribing trends of antipsychotics in youth receiving income assistance: results from a retrospective population database study

BMC Psychiatry

Stan P Kutcher²  Jean Hughes³  Steve Kisely¹  Charmaine Cooke⁵  David M Gardner⁴  Andrea L Murphy⁶ 

[1] University of Queensland, School of Population Health, Herston, QLD, 4006, Australia;Sun Life Financial Chair in Adolescent Mental Health, Dalhousie University/IWK Health Centre, 5850 University Ave, PO Box 9700, Halifax, NS, B3K 6R8, Canada;School of Nursing, Dalhousie University, 5869 University Avenue, PO Box 15000, Halifax, NS, B3H 4R2, Canada;Department of Psychiatry and College of Pharmacy, Dalhousie University, QEII HSC, AJLB 7517, 5909 Veterans' Memorial Lane, Halifax, NS, B3H 2E2, Canada;Department of Health and Wellness, Joseph Howe Building, 1690 Hollis Street, PO Box 488, Halifax, NS, B3J 2R8, Canada;College of Pharmacy and Department of Psychiatry, Dalhousie University, 5968 College St, PO Box 15000, Halifax, NS, B3H 4R2, Canada

关键词: Pharmacoepidemiology;    Retrospective studies;    Pediatrics;    Antipsychotics;   

Others  :  1123995
DOI  :  10.1186/1471-244X-13-198

 received in 2012-10-03, accepted in 2013-07-25,  发布年份 2013

【 摘 要 】

Background

Prescribing of antipsychotics (AP) to young people has increased in the last decade internationally. We aimed to characterize AP prescribing in a population of low-income youth in Nova Scotia, Canada.

Methods

We conducted a population database study of AP prescription claims and health services utilization by young people aged 25 years and younger receiving drug benefits through the publicly funded Pharmacare program between October 1, 2000 to September 30, 2007.

Results

Four percent (1715/43888) of youth receiving Pharmacare benefits filled AP prescriptions. The use of second generation antipsychotics (SGAs) significantly increased (p < 0.0001) in all age groups except 0-5 year olds, whereas first generation antipsychotic use significantly decreased. Pharmacare beneficiaries aged 21-25 years represented 45.2% of AP users. The majority (66%) of youth filling AP prescriptions had 2 or more psychiatric diagnoses. Most youth (76%) filled prescriptions for only one type of AP during the study period. Psychotic disorders were the most common indication for AP use except with risperidone, in which ADHD was the most likely reason for use. Co-prescribing of psychotropics was prevalent with antidepressants and mood stabilizers prescribed in 42% and 27% of AP users, respectively. General practitioners (GPs) prescribed incident APs most often (72%) followed by psychiatrists (16%). The age- and gender-adjusted rate of death was higher in AP users as compared to the age-matched general population of Nova Scotia.

Conclusions

SGA use increased significantly over seven years in a cohort of 0 to 25 years olds receiving Pharmacare benefits. Off-label use of APs was prevalent with ADHD and other non-psychotic disorders being common reasons for AP use. GPs initiated most AP prescriptions. Co-prescribing of other psychotropics, especially antidepressants and mood stabilizers, was prevalent even in younger age strata. This study raises further questions about AP prescribing in those 25 years of age and under, especially given the range of diagnoses and psychotropic co-prescribing.

【 授权许可】

   
2013 Murphy et al.; licensee BioMed Central Ltd.

【 图 表 】

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