Department of Pharmacy Practice, Chapman University School of Pharmacy, Irvine, CA, United States.
Hyundai Cancer Institute, CHOC Children's Hospital, Orange, CA, United States.
Front Public Health. 2024 Mar 5;12:1302144. doi: 10.3389/fpubh.2024.1302144. eCollection 2024.
Attention-deficit/hyperactivity disorder (ADHD) is one of the most common pediatric neurobehavioral disorders in the U.S. Stimulants, classified as controlled substances, are commonly used for ADHD management. We conducted an analysis of real-world stimulants dispensing data to evaluate the pandemic's impact on young patients (≤ 26 years) in California.
Annual prevalence of patients on stimulants across various California counties from 2019 and 2021 were analyzed and further compared across different years, sexes, and age groups. New patients initiating simulants therapy were also examined. A case study was conducted to determine the impact of socioeconomic status on patient prevalence within different quintiles in Los Angeles County using patient zip codes. Logistic regression analysis using was employed to determine demographic factors associated with concurrent use of stimulants with other controlled substances.
There was a notable reduction in prevalence of patients ≤26 years old on stimulants during and after the pandemic per 100,000 people (777 in 2019; 743 in 2020; 751 in 2021). These decreases were more evident among the elementary and adolescent age groups. The most prevalent age group on stimulants were adolescents (12-17 years) irrespective of the pandemic. A significant rise in the number of female patients using stimulants was observed, increasing from 107,957 (35.2%) in 2019 to 121,241 (41.1%) in 2021. New patients initiating stimulants rose from 102,754 in 2020 to 106,660 in 2021, with 33.2% being young adults. In Los Angeles County, there was an increasing trend in patient prevalence from Q1 to Q5 income quintiles among patients ≥6 years. Consistently each year, the highest average income quintile exhibited the highest prevalence. Age was associated with higher risk of concurrent use of benzodiazepines (OR, 1.198 [95% CI, 1.195-1.201], < 0.0001) and opioids (OR, 1.132 [95% CI, 1.130-1.134], < 0.0001) with stimulants.
Our study provides real-world information on dispensing of ADHD stimulants in California youth from 2019 to 2021. The results underscore the importance of optimizing evidence-based ADHD management in pediatric patients and young adults to mitigate disparities in the use of stimulants.
注意力缺陷多动障碍（ADHD）是美国最常见的儿科神经行为障碍之一。兴奋剂被归类为受控物质，通常用于 ADHD 管理。我们对现实世界中的兴奋剂配药数据进行了分析，以评估大流行对加利福尼亚年轻患者（≤26 岁）的影响。
分析了 2019 年和 2021 年加利福尼亚州不同县的各类患者使用兴奋剂的年度患病率，并进一步比较了不同年份、性别和年龄组的患病率。还检查了开始接受兴奋剂治疗的新患者。通过患者邮政编码，在洛杉矶县不同五分位数内，使用病例研究确定社会经济地位对患者患病率的影响。使用 logistic 回归分析确定与同时使用兴奋剂和其他受控物质相关的人口统计学因素。
在大流行期间和之后，每 100,000 人中接受≤26 岁的患者使用兴奋剂的人数显著减少（2019 年为 777 人；2020 年为 743 人；2021 年为 751 人）。这些减少在小学和青少年年龄组中更为明显。使用兴奋剂的最常见年龄组是青少年（12-17 岁），无论大流行与否。观察到女性患者使用兴奋剂的人数显著增加，从 2019 年的 107,957 人（35.2%）增加到 2021 年的 121,241 人（41.1%）。从 2020 年的 102,754 名新患者开始使用兴奋剂增加到 2021 年的 106,660 名，其中 33.2%为年轻人。在洛杉矶县，≥6 岁的患者中，从 Q1 到 Q5 收入五分位数的患者患病率呈上升趋势。每年，收入最高的五分位数都表现出最高的患病率。年龄与同时使用苯二氮䓬类药物（OR，1.198 [95% CI，1.195-1.201]，<0.0001）和阿片类药物（OR，1.132 [95% CI，1.130-1.134]，<0.0001）的风险增加有关。
我们的研究提供了 2019 年至 2021 年加利福尼亚州青少年 ADHD 兴奋剂配药的真实世界信息。结果强调了优化儿科患者和年轻成年人 ADHD 管理的重要性，以减轻兴奋剂使用方面的差异。
