Centre for Medicine Use and Safety, Monash University, Melbourne, VIC.
School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC.
Med J Aust. 2023 Jul 3;219(1):18-25. doi: 10.5694/mja2.51948. Epub 2023 May 14.
To determine longitudinal patterns of dispensing of antidepressant, anxiolytic, antipsychotic, psychostimulant, and hypnotic/sedative medications to children and adolescents in Australia during 2013-2021.
Retrospective cohort study; analysis of 10% random sample of Pharmaceutical Benefits Scheme (PBS) dispensing data.
PARTICIPANTS, SETTING: People aged 18 years or younger dispensed PBS-subsidised psychotropic medications in Australia, 2013-2021.
Population prevalence of dispensing of psychotropic medications to children and adolescents, by psychotropic class, gender, and age group (0-6, 7-12, 13-18 years).
The overall prevalence of psychotropic dispensing to children and adolescents was 33.8 per 1000 boys and 25.2 per 1000 girls in 2013, and 60.0 per 1000 boys and 48.3 per 1000 girls in 2021. The prevalence of psychotropic polypharmacy was 5.4 per 1000 boys and 3.7 per 1000 girls in 2013, and 10.4 per 1000 boys and 8.3 per 1000 girls in 2021. Prevalent dispensing during 2021 was highest for psychostimulants (boys, 44.0 per 1000; girls, 17.4 per 1000) and antidepressants (boys, 20.4 per 1000; girls, 33.8 per 1000). During 2021, the prevalence of dispensing was higher than predicted by extrapolation of 2013-2019 data for many classes, including antidepressants (boys: +6.1%; 95% CI, 1.1-11.1%; girls: +22.2%; 95% CI, 17.4-26.9%), and psychostimulants (boys: +14.5%; 95% CI, 8.0-21.1%; girls: +27.7%; 95% CI, 18.9-36.6%). The increases were greatest for girls aged 13-18 years (antidepressants: +20.3%; 95% CI, 16.9-23.7%; psychostimulants: +39.0%; 95% CI, 27.9-50.0%).
The prevalence of both psychotropic dispensing and psychotropic polypharmacy for children and adolescents were twice as high in 2021 as in 2013. The reasons and appropriateness of the marked increases in psychotropic dispensing during the COVID-19 pandemic, particularly to adolescent girls, should be investigated.
确定 2013-2021 年期间澳大利亚儿童和青少年抗抑郁药、抗焦虑药、抗精神病药、精神兴奋剂和催眠/镇静药的配药纵向模式。
回顾性队列研究；分析 10% 的药品福利计划（PBS）配药数据随机样本。
参与者、设置：2013-2021 年期间，澳大利亚年龄在 18 岁以下的人使用 PBS 补贴的精神药物。
儿童和青少年精神药物配药的人群患病率，按精神药物类别、性别和年龄组（0-6 岁、7-12 岁、13-18 岁）进行划分。
2013 年，男孩和女孩的总体精神药物配药率分别为每 1000 人中有 33.8 人和 25.2 人，2021 年分别为每 1000 人中有 60.0 人和 48.3 人。2013 年，男孩和女孩的精神药物合并用药率分别为每 1000 人中有 5.4 人和 3.7 人，2021 年分别为每 1000 人中有 10.4 人和 8.3 人。2021 年，精神兴奋剂（男孩：44.0/1000；女孩：17.4/1000）和抗抑郁药（男孩：20.4/1000；女孩：33.8/1000）的配药率最高。2021 年，许多类别的配药率高于 2013-2019 年数据外推的预测值，包括抗抑郁药（男孩：+6.1%；95%CI，1.1-11.1%；女孩：+22.2%；95%CI，17.4-26.9%）和精神兴奋剂（男孩：+14.5%；95%CI，8.0-21.1%；女孩：+27.7%；95%CI，18.9-36.6%）。13-18 岁女孩的增幅最大（抗抑郁药：+20.3%；95%CI，16.9-23.7%；精神兴奋剂：+39.0%；95%CI，27.9-50.0%）。
2021 年儿童和青少年的精神药物配药率和精神药物合并用药率均是 2013 年的两倍。应该调查在 COVID-19 大流行期间，特别是对青春期女孩，精神药物配药显著增加的原因和适当性。
