Ringeling Lisa T, Srivastava Aarushi, Gangapersad Ravish N, Bos Jens H J, de Winter Brenda C M, Hak Eelko, Hillegers Manon H J, Koch Birgit C P, Schuiling-Veninga Catharina C M, Dierckx Bram
Department of Hospital Pharmacy, Erasmus University Medical Center, Rotterdam, The Netherlands.
Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Rotterdam, The Netherlands.
Eur Child Adolesc Psychiatry. 2025 Jun 23. doi: 10.1007/s00787-025-02791-w.
The Youth Act, implemented by the Dutch government in 2015, aimed to provide more efficient, coherent, and cost-effective care tailored to the specific needs of children, while also reducing medicalization. Between 2003 and 2013, there was a four-fold increase in methylphenidate prescriptions among Dutch children aged 4 to 18 years. However, the impact of the Youth Act on the ADHD medication dispensing remains unassessed. This study investigated changes in ADHD medication dispensing patterns among Dutch youth following the implementation of the Youth Act.
A before-after retrospective cohort study was conducted using data from the Dutch community pharmacy-based IADB.nl database among 137,684 youths aged 0-19 years using ADHD medication between 2010 and 2022.
A significant decrease in overall ADHD medication dispensing prevalence rates per thousand youths was observed in 2022 compared to 2015 (35.2 vs. 45.7, p < 0.001). Methylphenidate accounted for approximately 87% of all ADHD medication dispensing. Incidence rates decreased significantly among children aged 7-12 from 2015 to 2022 (9 vs. 7.3, p < 0.001), while incidence rates increased significantly in adolescent youths (4 vs. 4.8, p = 0.008), particularly among adolescent females (3.5 vs. 5.3, p < 0.001). Females had lower prevalence rates and shorter durations of ADHD medication use compared to males, with no difference in daily dose observed.
ADHD medication dispensing among Dutch youth declined following the 2015 implementation of the Youth Act. However, other factors such as the DSM-5 revision, COVID-19, and medication shortages likely contributed to this decrease, suggesting a multifactorial explanation for the observed changes in ADHD medication dispensing.
荷兰政府于2015年实施的《青年法案》旨在提供更高效、连贯且具成本效益的护理，以满足儿童的特定需求，同时减少医学化现象。2003年至2013年间，荷兰4至18岁儿童的哌甲酯处方量增长了四倍。然而，《青年法案》对注意力缺陷多动障碍（ADHD）药物配给的影响尚未得到评估。本研究调查了《青年法案》实施后荷兰青年ADHD药物配给模式的变化。
采用基于荷兰社区药房的IADB.nl数据库的数据，对2010年至2022年间使用ADHD药物的137,684名0至19岁青年进行了一项前后回顾性队列研究。
与2015年相比，2022年每千名青年中ADHD药物配给总体患病率显著下降（35.2对45.7，p < 0.001）。哌甲酯约占所有ADHD药物配给的87%。2015年至2022年间，7至12岁儿童的发病率显著下降（9对7.3，p < 0.001），而青少年的发病率显著上升（4对4.8，p = 0.008），尤其是在青少年女性中（3.5对5.3，p < 0.001）。与男性相比，女性的患病率较低，ADHD药物使用持续时间较短，每日剂量无差异。
2015年《青年法案》实施后，荷兰青年的ADHD药物配给量有所下降。然而，其他因素，如《精神疾病诊断与统计手册》第5版（DSM-5）的修订、新冠疫情和药物短缺，可能也促成了这种下降，这表明对观察到的ADHD药物配给变化存在多因素解释。
