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Trends in the prevalence of chronic medication use in children: 2002-2005
Emily R Cox1, Donna R Halloran, Sharon M Homan
1Express Scripts, Inc, St Louis, Missouri, USA. ecox@express-scripts.com
Insights
Chronic medication use in children, including asthma, ADHD, and diabetes drugs, significantly increased from 2002 to 2005. This trend was particularly pronounced in adolescent girls, highlighting a growing need to understand contributing factors.
Area of Science:
- Pediatric pharmacology
- Public health
- Epidemiology
Background:
- Chronic conditions are increasingly diagnosed in children.
- Understanding medication use trends is crucial for public health.
- Pediatric prescription patterns require ongoing surveillance.
Purpose of the Study:
- To estimate the quarterly prevalence of chronic medication use in children aged 5 to 19.
- To evaluate trends in the use of specific medication classes from 2002 to 2005.
Main Methods:
- Cross-sectional study utilizing ambulatory prescription claims data.
- Analysis of a nationally representative sample of over 3.5 million commercially insured children.
- Quarterly prevalence measurement for antihypertensives, antihyperlipidemics, type 2 antidiabetics, antidepressants, ADHD medications, and asthma-controller therapy.
Main Results:
- Chronic medication use prevalence varied by therapy class, with asthma medications highest and antihyperlipidemics lowest in 2002.
- Prevalence rates were generally higher in older teens (15-19 years) for most classes, except asthma medications.
- Significant increases observed: type 2 antidiabetics (doubled), asthma medications (46.5%), ADHD medications (40.4%), and antihyperlipidemics (15%).
- Adolescent girls showed dramatically higher growth rates than boys for type 2 antidiabetics, ADHD medications, and antidepressants.
Conclusions:
- Overall prevalence of chronic medication use in children increased across all evaluated therapy classes.
- Further research is needed to identify factors driving these trends, such as increased chronic disease risk, enhanced screening, and earlier initiation of drug therapy.
Objective:
Our goal was to estimate the quarterly prevalence of and evaluate trends for chronic medication use in children.
Patients And Methods:
A cross-sectional study of ambulatory prescription claims data from 2002 to 2005 was conducted for a nationally representative sample of >3.5 million commercially insured children who were 5 to 19 years old. Prevalence of chronic medication use was measured quarterly for antihypertensives, antihyperlipidemics, type 2 antidiabetics, antidepressants, attention-deficit disorder and attention-deficit/hyperactivity disorder medications, and asthma-controller therapy.
Results:
First-quarter 2002 baseline prevalence of chronic medication use per 1000 child beneficiaries ranged from a high of 29.5 for antiasthmatics to a low of 0.27 for antihyperlipidemics. Except for asthma medication use, prevalence rates were higher for older teens aged 15 to 19 years. During the study period, the prevalence rate for type 2 antidiabetic agents doubled, driven by 166% and 135% increases in prevalence among females aged 10 to 14 and 15 to 19 years, respectively. Therapy classes with double-digit growth in prevalence of use were asthma medications (46.5%), attention-deficit disorder and attention-deficit/hyperactivity disorder medications (40.4%), and antihyperlipidemics (15%). Prevalence of use growth was more moderate for antihypertensives and antidepressants (1.8%). Rates of growth were dramatically higher among girls than boys for type 2 antidiabetics (147% vs 39%), attention-deficit disorder and attention-deficit/hyperactivity disorder medications (63% vs 33%), and antidepressants (7% vs -4%).
Conclusions:
Prevalence of chronic medication use in children increased across all therapy classes evaluated. Additional study is needed into the factors influencing these trends, including growth in chronic disease risk factors, greater awareness and screening, and greater affinity toward early use of drug therapy in children.
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