Epidemic Intelligence Service, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop S106-8, Atlanta, GA, 30341-3717, United States; Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop S106-8, Atlanta, GA, 30341-3717, United States.
Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop S106-8, Atlanta, GA, 30341-3717, United States.
Drug Alcohol Depend. 2020 Dec 1;217:108297. doi: 10.1016/j.drugalcdep.2020.108297. Epub 2020 Sep 15.
Stimulant medications are commonly prescribed for the treatment of attention-deficit/hyperactivity disorder; however, they also have high potential for diversion and misuse. We estimated national stimulant dispensing trends from 2014 to 2019 and differences in dispensing by age, sex, state, prescriber specialty, payor type, patient copay, and stimulant type.
We calculated rates of stimulant dispensing using IQVIA National Prescription Audit (NPA) New to Brand, NPA Regional, and NPA Extended Insights data, which provide dispensing estimates from approximately 49,900 pharmacies representing 92 % of prescriptions dispensed in the United States. Average annual percent change (AAPC) from 2014 to 2019 was analyzed using Joinpoint regression.
From 2014 to 2019, the national annual rate of stimulant dispensing increased significantly from 5.6 to 6.1 prescriptions per 100 persons. Rates differed by prescription stimulant type, with increases occurring among both amphetamine-type stimulants and long-acting stimulants. Rates among females (AAPC = 3.6 %; P = 0.001) and adults aged 20-39 years (AAPC=6.7 %; P = 0.002), 40-59 years (AAPC=9.7 %; P < 0.001), and ≥60 years (AAPC = 6.9 %; P = 0.001) increased significantly during the study period. Stimulant dispensing rates varied substantially across states, ranging from 1.0 per 100 in Hawaii to 13.6 per 100 in Alabama.
National stimulant dispensing rates increased from 2014 to 2019, driven by notable increases among females and adults aged ≥20 years. These trends should be considered when prescribing stimulants given growing concerns over prescription stimulant diversion, misuse, and related health harms.
兴奋剂类药物常用于治疗注意力缺陷多动障碍，但它们也具有较高的滥用和转移风险。本研究旨在估计 2014 年至 2019 年期间全国范围内兴奋剂的配药趋势，并评估不同年龄、性别、州、处方医生专业、支付类型、患者共付额和兴奋剂类型之间的配药差异。
我们使用 IQVIA 全国处方审核（NPA）新品牌、NPA 区域和 NPA 扩展洞察数据计算了兴奋剂的配药率，这些数据提供了来自美国约 49900 家药店的配药估计值，占美国配药量的 92%。采用 Joinpoint 回归分析 2014 年至 2019 年的平均年百分比变化（AAPC）。
2014 年至 2019 年，全国范围内兴奋剂的年配药率从 5.6 增加到 6.1，每 100 人处方 1 剂。不同的处方兴奋剂类型存在差异，安非他命类兴奋剂和长效兴奋剂的配药率均有所增加。女性（AAPC=3.6%；P=0.001）和 20-39 岁（AAPC=6.7%；P=0.002）、40-59 岁（AAPC=9.7%；P<0.001）和≥60 岁（AAPC=6.9%；P=0.001）年龄组的配药率在研究期间显著增加。各州之间的配药率差异很大，从夏威夷的 1.0 增加到阿拉巴马州的 13.6。
2014 年至 2019 年，全国范围内的兴奋剂配药率有所增加，主要是由于女性和≥20 岁成年人的配药率显著增加。鉴于对处方兴奋剂滥用、误用和相关健康危害的担忧日益增加，在开兴奋剂处方时应考虑这些趋势。
