Newlove-Delgado Tamsin, Hamilton William, Ford Tamsin J, Stein Ken, Ukoumunne Obioha C
University of Exeter Medical School, St. Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK.
NIHR CLAHRC South West Peninsula [PenCLAHRC], University of Exeter Medical School, Exeter, UK.
Atten Defic Hyperact Disord. 2019 Sep;11(3):255-262. doi: 10.1007/s12402-019-00288-6. Epub 2019 Feb 7.
Guidance on management of attention deficit hyperactivity disorder (ADHD) in the UK was issued by the National Institute for Clinical Excellence in 2008. No UK study has examined all psychotropic prescribing in young people with ADHD since the introduction of the guidance; this is especially relevant due to the high prevalence of psychiatric comorbidity in this population. The aim of this study was to describe primary care prescribing of ADHD and other psychotropic medications for young people with ADHD. The analysis of records of patients with an ADHD diagnosis in the UK Clinical Practice Research Datalink from 2005 to 2013 was performed. Estimation of the prevalence of prescribing of ADHD and other psychotropic medications over 8-year follow-up for cases aged 10-20 years in 2005 was carried out. Of 9390 ADHD cases, 61.6% [95% confidence interval (CI) 60.6-62.5%] had a prescription at some point for ADHD medication. Prescribing of other psychotropic medications was higher in girls than in boys (36.4% vs. 22.7%; p < 0.001). ADHD prescribing prevalence declined steeply between the ages of 16 and 18 from 37.8% (95% CI 36.6-38.9) to 23.7% (95% CI 22.7-24.6%). There was a parallel increase in prescribing of other psychotropics from 3.8% (95% CI 3.4-4.3%) to 6.6% (95% CI 6.0-7.3%). There is scope to optimise the management of ADHD and psychiatric comorbidities in young people, and there is a need for sustainable models of ADHD care for young adults, supported by appropriate training and specialist services.
英国国家临床优化研究所于2008年发布了关于注意缺陷多动障碍（ADHD）管理的指南。自该指南出台以来，英国尚无研究对患有ADHD的年轻人的所有精神药物处方进行过调查；鉴于该人群中精神疾病合并症的高患病率，这一点尤为重要。本研究的目的是描述针对患有ADHD的年轻人的ADHD及其他精神药物的初级保健处方情况。对英国临床实践研究数据链中2005年至2013年被诊断为ADHD的患者记录进行了分析。对2005年年龄在10至20岁的病例进行了为期8年的随访，以估计ADHD及其他精神药物的处方患病率。在9390例ADHD病例中，61.6%[95%置信区间（CI）60.6 - 62.5%]在某个时间点有ADHD药物处方。女孩中其他精神药物的处方率高于男孩（36.4%对22.7%；p < 0.001）。ADHD处方患病率在16岁至18岁之间急剧下降，从37.8%（95%CI 36.6 - 38.9）降至23.7%（95%CI 22.7 - 24.6%）。同时，其他精神药物处方率从3.8%（95%CI 3.4 - 4.3%）平行上升至6.6%（95%CI 6.0 - 7.3%）。有必要优化对年轻人ADHD及精神疾病合并症的管理，并且需要在适当培训和专业服务的支持下，为年轻成年人建立可持续的ADHD护理模式。
