Huissoud T, Jeannin A, Dubois-Arber F
Institut universitaire de médecine sociale et préventive, université de Lausanne, 17, rue du Bugnon, 1005 Lausanne, Suisse.
Rev Epidemiol Sante Publique. 2007 Oct;55(5):357-63. doi: 10.1016/j.respe.2007.05.008. Epub 2007 Sep 21.
The estimated prevalence of Attention Deficit Hyperactivity Disorder (ADHD) reported in European countries is 2 to 5% of school age children. Political concern has been expressed in Switzerland about possible over treatment with methylphenidate. The purpose of this research, commissioned by the regional public health authority, was to assess the prescription of methylphenidate (Ritalin) for children as a treatment of ADHD.
The regional health authority collected all prescriptions of Ritalin delivered in pharmacies during 2002. Data available from prescriptions and analyzed were: age, sex and place of residence of the patient, dosage prescribed, date of prescription, place of practice and medical specialization of doctors. Only patients living in the canton of Vaud and aged less than 20 years were included in the analysis.
Six hundred and ninety-seven patients, aged less than 20 years, received Ritalin in 2002. The mean age was 12.1 years (median: 12 years; range: 3-19), 15% were female. These patients represented 0.74% of the 5-14 years old population living in the canton of Vaud. Eighty percent of patients had a prescription from a specialist (pediatrician or psychiatrist) during the year.
Less than 1% of the young population receives methylphenidate in the canton of Vaud. Dosage complies with the recommendations of the Swiss Medic Compendium. The large majority of patients receive prescriptions for methylphenidate from specialists. A new study based on the 2005 data will be conducted to follow changes in the prescription of Ritalin.
据报道，欧洲国家注意力缺陷多动障碍（ADHD）在学龄儿童中的估计患病率为2%至5%。瑞士已表达了对哌甲酯可能过度治疗的政治关注。这项由地区公共卫生当局委托开展的研究旨在评估哌甲酯（利他林）作为治疗ADHD对儿童的处方情况。
地区卫生当局收集了2002年药房发放的所有利他林处方。可从处方中获取并分析的数据包括：患者的年龄、性别、居住地点、处方剂量、处方日期、执业地点以及医生的医学专业。分析仅纳入居住在沃州且年龄小于20岁的患者。
2002年，697名年龄小于20岁的患者接受了利他林治疗。平均年龄为12.1岁（中位数：12岁；范围：3至19岁），15%为女性。这些患者占居住在沃州5至14岁人口的0.74%。80%的患者在该年度有专科医生（儿科医生或精神科医生）开具的处方。
在沃州，不到1%的年轻人使用哌甲酯。剂量符合《瑞士药品汇编》的建议。绝大多数患者从专科医生处获得哌甲酯处方。将基于2005年的数据开展一项新研究，以追踪利他林处方的变化情况。
