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Trends in medication prescribing for pediatric sleep difficulties in US outpatient settings
Sasko D Stojanovski1, Rafia S Rasu, Rajesh Balkrishnan
1Division of Pharmacy Practice and Administration, The Ohio State University College of Pharmacy, Columbus, OH 43210, USA,
Insights
Physicians frequently prescribed medications for children
Area of Science:
- Pediatric Sleep Medicine
- Pharmacology
- Public Health
Background:
- Sleep difficulties are common in children.
- Medication use for pediatric sleep issues requires careful consideration of safety and efficacy.
- Understanding prescribing trends is crucial for improving child health outcomes.
Purpose of the Study:
- To examine physician prescribing trends for children with sleep difficulties in US outpatient settings.
- To investigate the rate of prescribing medications with high abuse potential for pediatric sleep issues.
Main Methods:
- Cross-sectional study using National Ambulatory Medical Care Survey (NAMCS) data from 1993-2004.
- Included patients aged 17 years or younger with sleep difficulties.
- Analyzed office visits with relevant ICD-9 codes and sleep difficulty as the reason for visit.
Main Results:
- Approximately 18.6 million pediatric outpatient visits for sleep difficulties occurred between 1993-2004.
- Eighty-one percent of these visits resulted in a medication prescription.
- A significant proportion of prescribed medications lacked FDA-approved labeling for pediatric use.
Conclusions:
- Physicians commonly prescribe medications for pediatric sleep difficulties in outpatient settings.
- The frequent use of unapproved medications for this population is a significant concern.
- Further research is needed to ensure safe and effective pharmacotherapy for childhood sleep problems.
Objectives:
This study examined trends in physician-prescribing of medications for children with sleep difficulties in outpatient settings in the US. Additionally, we explored the incidence of physician prescribing patterns of medications with high abuse potential for children with sleep difficulties.
Methods:
A cross-sectional study was conducted on patients aged < or =17 years with sleep difficulties from 1993-2004 using data from the National Ambulatory Medical Care Survey (NAMCS). Office visits were considered related to sleep difficulties if relevant ICD-9 codes were recorded and if sleep difficulties were reported as the reason for the visits. Medications were retrieved using the NAMCS drug codes, and all analyses were weighted to determine national estimates.
Results:
During 1993 to 2004, approximately 18.6 million visits occurred for sleep related difficulty in children. The highest percentage of visits were by school-aged children (6 to 12 years). Pediatricians saw 35% of patients, psychiatrists saw 24%, and general/family practice physicians saw 13% of the patients. Eighty-one percent of visits among children with sleep difficulties resulted in a prescription for a medication. Many of these medications prescribed lack FDA approved labeling to assure their effectiveness and safety in this population.
Conclusion:
The findings of this study suggest that physicians frequently prescribed medications for sleep difficulties in children in US outpatient settings. Of particular concern is prescribing of many unapproved medications for this population.
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