Pringsheim Tamara, Stewart David G, Chan Parco, Tehrani Ali, Patten Scott B
Department of Clinical Neurosciences, Psychiatry, Pediatrics and Community Health Sciences, Mathison Centre for Mental Health Research and Education, University of Calgary, Calgary, Canada.
IQVIA Canada, Ottawa, Canada.
J Child Adolesc Psychopharmacol. 2019 Dec;29(10):740-745. doi: 10.1089/cap.2019.0018. Epub 2019 Jul 29.
The goal of this study was to characterize the frequency and trends of psychotropic drug prescribing in Canadian children from 2010 to 2016 and to compare these results with a previous study conducted between 2005 and 2009. Using a national physician panel survey database from IQVIA Canada, aggregated frequencies of written prescriptions and therapeutic indications for antipsychotics, attention-deficit/hyperactivity disorder (ADHD) medications (psychostimulants and nonstimulants), and antidepressants were analyzed in children. Changes in frequency of written prescriptions and therapeutic indications are presented using descriptive statistics. Written prescriptions for antipsychotics decreased by 10% from 2010 to 2016, in contrast to a 114% increase in written prescriptions for antipsychotics observed between 2005 and 2009. Written prescriptions for psychostimulants and antidepressants rose by 35% and 27%, respectively, between 2012 and 2016, comparable with previous results. The most common reasons for recommending an antipsychotic were ADHD and conduct disorder, although there appears to be a downward trend for ADHD compared with other conditions. In contrast, the share of written prescriptions for antipsychotics for autism increased 34% over the study period. Within the second-generation antipsychotics, written prescriptions for aripiprazole increased. An increase in the use of guanfacine extended release for ADHD was also observed. Several factors may be involved in stabilization and small decrease in antipsychotic use in recent years, including physician and patient awareness of adverse effects related to antipsychotic use, knowledge implementation strategies advocating short-term and judicious use of antipsychotics in children, and the approval of guanfacine extended release for use in Canada for ADHD in 2013.
本研究的目的是描述2010年至2016年加拿大儿童精神药物处方的频率和趋势，并将这些结果与2005年至2009年进行的一项先前研究进行比较。利用IQVIA加拿大公司的全国医师小组调查数据库，分析了儿童抗精神病药物、注意力缺陷多动障碍（ADHD）药物（精神兴奋剂和非兴奋剂）以及抗抑郁药的书面处方汇总频率和治疗适应症。书面处方频率和治疗适应症的变化采用描述性统计呈现。从2010年到2016年，抗精神病药物的书面处方减少了10%，相比之下，2005年至2009年期间抗精神病药物的书面处方增加了114%。2012年至2016年期间，精神兴奋剂和抗抑郁药的书面处方分别增加了35%和27%，与先前结果相当。推荐使用抗精神病药物的最常见原因是ADHD和品行障碍，不过与其他病症相比，ADHD的比例似乎呈下降趋势。相比之下，在研究期间，用于自闭症的抗精神病药物书面处方比例增加了34%。在第二代抗精神病药物中，阿立哌唑的书面处方增加。还观察到用于ADHD的缓释胍法辛的使用有所增加。近年来抗精神病药物使用趋于稳定且略有下降可能涉及几个因素，包括医生和患者对抗精神病药物使用相关不良反应的认识、倡导在儿童中短期和明智使用抗精神病药物的知识实施策略，以及2013年缓释胍法辛在加拿大获批用于ADHD。
