Kinlaw Alan C, Jonsson Funk Michele, Steiner Michael J, Conover Mitchell M, Pate Virginia, Wu Jennifer M
1 Department of Epidemiology, University of North Carolina at Chapel Hill, NC, USA.
2 Center for Women's Health Research, University of North Carolina at Chapel Hill, NC, USA.
Clin Pediatr (Phila). 2017 Jan;56(1):55-64. doi: 10.1177/0009922816641366. Epub 2016 Jul 19.
Bladder-related issues such as nocturnal enuresis and incontinence have long been a part of general pediatric practice. Increasingly, clinicians are prescribing medications directed at a variety of types of bladder dysfunction, but no prior population-based data exist. We used MarketScan health care claims data on 32 074 638 insured children to estimate utilization patterns by age, sex, year, and geographic region in the United States from 2000 to 2013, and to assess related diagnosis codes. Approximately 1 in 500 children filled an antimuscarinic prescription. The most common prescriptions were for oxybutynin (78%) and tolterodine (17%). Rates were highest at ages 6 to 10 years (65/100 000 person-months), 31% higher for girls versus boys, peaked in 2011 (44/100 000 person-months), and were highest in the Midwest (59/100 000 person-months). Seventy-three percent of children with prescriptions had diagnosis codes for genitourinary symptoms, and 13% had codes for congenital anomalies. Research is needed regarding the comparative effectiveness and safety of these drugs in children.
诸如夜间遗尿和尿失禁等与膀胱相关的问题长期以来一直是儿科普通诊疗的一部分。越来越多的临床医生针对各种类型的膀胱功能障碍开出处方药物，但此前尚无基于人群的数据。我们利用市场扫描医疗保健理赔数据，该数据涉及32074638名参保儿童，以估计2000年至2013年美国各年龄段、性别、年份和地理区域的用药模式，并评估相关诊断编码。大约每500名儿童中就有1人开具抗毒蕈碱类处方。最常见的处方药物是奥昔布宁（78%）和托特罗定（17%）。使用率在6至10岁时最高（每10万人月65例），女孩比男孩高31%，在2011年达到峰值（每10万人月44例），在中西部地区最高（每10万人月59例）。开具处方的儿童中有73%有泌尿生殖系统症状的诊断编码，13%有先天性异常的编码。需要对这些药物在儿童中的相对有效性和安全性进行研究。
