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爱尔兰儿童和青少年使用精神药物的近期趋势。

Recent trends in psychotropic medication use in children and adolescents in Ireland.

作者信息

Parkin Rebecca, Bennett Kathleen, Nicholas Fiona Mc, Hayden John C

机构信息

School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland.

Data Science Centre, School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland.

出版信息

Eur Child Adolesc Psychiatry. 2025 Mar;34(3):997-1009. doi: 10.1007/s00787-024-02530-7. Epub 2024 Aug 8.

Abstract

In response to concerns regarding overprescribing of psychotropic medication in children/adolescents, this study examined trends in psychotropic medication use in Ireland by age group and gender. A retrospective, repeated, cross-sectional study of the Irish pharmacy claims database was conducted. Yearly prevalence of children/adolescents receiving dispensed psychotropic medications was analysed from January 2017 to December 2021 and compared across years, age groups (5-15 years, and stratified as 5-11 and 12-15 years) and gender. Yearly prevalence was defined as the mean number of patients in receipt of medication per month per 1000 eligible population during a given calendar year. Negative binomial regression was used to examine the association of year, age group and gender on prevalence. Prevalence ratios (PRs) per year (average change in prevalence between each year) were presented with 95% confidence intervals (CIs). The prevalence of included psychotropic medications dispensed in the 5-15 years group increased from 6.41 (95% CI: 6.22, 6.59) in 2017 to 8.46 (95% CI: 8.26, 8.68) in 2021 per 1000 eligible population (32% increase). The PR per year (adjusting for age category and gender) was 1.07 (95% CI: 1.035, 1.107; p < 0.001). An increasing trend over time was also observed for all individual drug classes. These findings suggest increased use of psychotropic medication in children/adolescents from 2017 to 2021. However, despite increased prevalence over time, comparison with the literature shows that psychotropic medication use in Ireland remains lower than international comparators.

摘要

针对对儿童/青少年精神药物过度处方的担忧,本研究按年龄组和性别调查了爱尔兰精神药物使用趋势。对爱尔兰药房索赔数据库进行了一项回顾性、重复横断面研究。分析了2017年1月至2021年12月接受配发精神药物的儿童/青少年的年度患病率,并按年份、年龄组(5至15岁,进一步分为5至11岁和12至15岁)和性别进行比较。年度患病率定义为给定日历年度内每1000名符合条件人群中每月接受药物治疗的患者平均人数。使用负二项回归分析年份、年龄组和性别与患病率之间的关联。给出了每年的患病率比值(PRs)(每年患病率的平均变化)及其95%置信区间(CIs)。在5至15岁年龄组中,每1000名符合条件人群中配发的纳入精神药物的患病率从2017年每1000人的6.41(95%CI:6.22,6.59)增加到2021年的8.46(95%CI:8.26,8.68)(增加了32%)。每年的PR(根据年龄类别和性别调整)为1.07(95%CI:1.035,1.107;p < 0.001)。所有单个药物类别也观察到随时间的上升趋势。这些发现表明,2017年至2021年期间儿童/青少年对精神药物的使用有所增加。然而,尽管患病率随时间增加,但与文献比较表明,爱尔兰精神药物的使用仍低于国际可比水平。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9b9b/11909023/3df86effa26e/787_2024_2530_Fig1_HTML.jpg

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