Influence of socioeconomic status on antipsychotic prescriptions among youth in France

BMC Psychiatry

Research Article

Olivier Bonnot¹  Paula Herrera²  Caroline Vigneau³  Mélanie Dufresne³  Anne Sauvaget⁴  Emmanuelle Michaud⁵  Anicet Chaslerie⁵  Jacques Pivette⁵ 

[1] Department of Child and Adolescent Psychiatry, University Hospital of Nantes, Nantes, France;Department of Child and Adolescent Psychiatry, University of Nantes, CHU de Nantes, 55 rue St Jacques, 44 000, Nantes, France;Department of Child and Adolescent Psychiatry, University Hospital of Nantes, Nantes, France;Medical Department, French National Health Insurance (DRSM), Nantes, France;Department of Pharmacology, University Hospital of Nantes, Nantes, France;Department of Psychiatry, University Hospital of Nantes, Nantes, France;Grupo de Investigación en Neurociencias NeURos, Universidad del Rosario, Bogota, Colombia;

关键词: Autism Spectrum Disorder;    Risperidone;    Aripiprazole;    Paliperidone;    Amisulpride;   

DOI  :  10.1186/s12888-017-1232-3

 received in 2016-04-07, accepted in 2017-02-07,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundRecent studies analysing the trends in antipsychotic (AP) prescriptions for children and adolescents have raised concerns regarding the influence of socioeconomic status. Previous findings have also shown variable prescription rates for first-generation (FG) and second-generation (SG) APs.MethodOur objectives were to assess the proportion of patients from low-income families receiving APs and the most commonly prescribed APs in France. We conducted a descriptive analysis of AP drugs dispensed during a 1-year period (July 1, 2013–June 30, 2014) in a northwestern region of France with 941,857 subjects less than 18 years old. All data were extracted from an exhaustive, individual and anonymous social security database. We obtained each subject’s socioeconomic status (by identifying their affiliation with a specific social security program) and also collected sociodemographic data, drug type, prescribing and dispensing dates and amount, and prescriber type (e.g., hospital physician, general practitioner, psychiatrist, paediatrician).ResultsThere were two main novel findings. First, we found that the proportion of patients with AP prescriptions was nearly ten times higher in low-income families than in the general population: 35.9% of CMU-C patients compared to 3.7% in all of Pays de la Loire (X2 = 7875.1, p < 0.001). Additionally, we found a higher rate of FGAP than SGAP prescriptions (65% vs. 57%).ConclusionsOur study suggests two types of AP misuse that could provide interesting targets for public healthcare interventions.First, our results strongly suggest an over-representation of patients from low-income families. Low-income families primarily resided in areas with low physician density and appeared to receive drugs to treat their conditions more frequently than other individuals. This increased prescription rate is a public health issue, potentially requiring political action. Second, the use of FGAPs did not adhere to the latest recommendations for drug use in this population, and this discrepancy should be addressed with informational campaigns targeted to medical practitioners.

【 授权许可】

CC BY   
© The Author(s). 2017