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Do Hospital and Community SSRI Usage Patterns in Children and Adolescents Match the Evidence?
Rebecca Ronsley1, Dean Elbe, Derryck H Smith
1Research Assistant, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia.
Summary
Selective serotonin reuptake inhibitor (SSRI) prescribing for pediatric patients in British Columbia largely aligns with evidence-based guidelines. Hospital prescribing patterns more closely reflect available literature than community outpatient practices.
Area of Science:
- Pediatric Psychiatry
- Pharmacology
- Evidence-Based Medicine
Background:
- Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for pediatric mental health conditions.
- Understanding prescribing patterns is crucial for ensuring adherence to evidence-based practices.
Purpose of the Study:
- To review SSRI prescribing patterns in children and adolescents within a hospital and provincial database.
- To evaluate if these prescribing practices align with published evidence and clinical recommendations.
Main Methods:
- Conducted a PubMed search for randomized controlled trials on SSRI efficacy in pediatric populations.
- Analyzed inpatient pharmacy data from BC Children's Hospital (BCCH) and the BC Pharmacare database for SSRI prescriptions (2005-2009) in patients under 19.
Main Results:
- Fluoxetine was the most frequently prescribed SSRI in both BCCH inpatients and provincial outpatients.
- Prescribing patterns for most SSRIs in both settings were generally consistent with evidence for depressive and anxiety disorders.
- Hospital prescribing more closely mirrored available literature compared to community outpatient prescribing.
Conclusions:
- SSRI prescribing patterns at BC Children's Hospital are consistent with pediatric evidence.
- Provincial outpatient and inpatient SSRI prescriptions generally follow national guidelines, with minor exceptions.
- Hospital-based SSRI use demonstrates closer alignment with scientific literature than community-based use.
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