Andersen Nanna Maria, Árnadóttir Ásthildur, Willadsen Tora Grauers, Overbeck Gritt
Department of Public Health, Center for General Practice, University of Copenhagen, Copenhagen, Denmark.
Research Unit for General Practice, Region Zealand, Denmark.
Scand J Prim Health Care. 2025 Mar;43(1):120-130. doi: 10.1080/02813432.2024.2407877. Epub 2024 Sep 30.
The prevalence of sleep disorders and use of sleep medication, particularly melatonin, are rising among adolescents and young adults (13-24 years). In Denmark, melatonin is approved for use in children with autism and ADHD up to 18 years of age, with other prescriptions being off-label in these age groups. The perspectives of medical practitioners on prescribing sleep medications to this age group remain largely unexplored.
This study aims to investigate the considerations of general practitioners (GPs) and child and adolescent psychiatrists (psychiatrists) when prescribing and deprescribing sleep medications for 13-24-year-olds.
We conducted qualitative semi-structured interviews with 10 GPs and six psychiatrists. Data were analyzed using an inductive approach.
Psychiatrists typically prescribed melatonin with the expectation that deprescription would occur in general practice. Despite the universal goal of deprescription, it was hindered by various challenges. GPs identified patient motivation and a clear focus on deprescription as facilitative factors and expressed a need for enhanced emphasis on these aspects in general practice.
The findings align with existing prescription trends and literature on factors that promote and inhibit deprescription. The study underscores the complexities of deprescribing sleep medications for adolescents and young adults, suggesting the need for expanded guidelines and enhanced continuing education for GPs.
The research highlights significant discrepancies among medical practitioners regarding the deprescription process of sleep medications for young individuals, complicated by multiple factors. This underscores the need for better guidelines and further studies.
睡眠障碍的患病率以及睡眠药物的使用，尤其是褪黑素的使用，在青少年和青年（13 - 24岁）中呈上升趋势。在丹麦，褪黑素被批准用于18岁以下患有自闭症和注意力缺陷多动障碍的儿童，在这些年龄组中其他处方属于超说明书用药。医疗从业者对于给这个年龄组开睡眠药物的观点在很大程度上仍未得到探索。
本研究旨在调查全科医生（GPs）以及儿童和青少年精神科医生（精神科医生）在为13 - 24岁人群开具和停用睡眠药物时的考虑因素。
我们对10名全科医生和6名精神科医生进行了定性半结构化访谈。使用归纳法对数据进行分析。
精神科医生通常开具褪黑素时期望在全科医疗中能实现停药。尽管停药是普遍目标，但受到各种挑战的阻碍。全科医生将患者动机和对停药的明确关注确定为促进因素，并表示在全科医疗中需要更加强调这些方面。
研究结果与现有的处方趋势以及关于促进和抑制停药因素的文献一致。该研究强调了为青少年和青年停用睡眠药物的复杂性，表明需要扩展指南并加强对全科医生的继续教育。
该研究突出了医疗从业者在为年轻人停用睡眠药物过程中存在的显著差异，且受到多种因素的影响。这凸显了制定更好的指南和进一步研究的必要性。
