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General practitioner prescribing trends among pediatric patients in the United Kingdom: 1998-2018
Reem Masarwa1,2, Claire Lefebvre3, Robert W Platt1,2,4
1Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada.
Insights
Pediatric prescribing trends show increased use of ADHD and GERD medications, alongside decreased use of cough preparations and analgesics. Systemic antibiotic prescribing remained stable.
Area of Science:
- Pediatric pharmacology
- Drug utilization research
- Public health
Background:
- Understanding pediatric prescribing patterns is crucial for optimizing child health outcomes.
- Long-term trends in medication use among children and adolescents require continuous monitoring.
- Previous studies have indicated shifts in prescribing habits, necessitating updated analyses.
Purpose of the Study:
- To analyze prescribing trends for 17 therapeutic drug categories in UK children and adolescents from 1998 to 2018.
- To specifically examine changes in the use of systemic antibiotics, analgesics, and antidepressants.
- To identify significant shifts in pediatric medication utilization over a 20-year period.
Main Methods:
- A retrospective cohort study utilizing UK population data from 1998 to 2018.
- Inclusion of children and adolescents aged 0-18 years.
- Calculation of prescription rates per 10,000 person-years and analysis of changes using Poisson regression.
Main Results:
- Prescribing rates increased for attention deficit hyperactivity disorder (ADHD) drugs (+15%), anxiolytics/hypnotics (+14%), and gastroesophageal reflux disease (GERD) drugs (+8%).
- Prescribing rates decreased for cough preparations (-6%) and analgesics (-3%).
- No significant changes were observed for systemic antibiotics; however, specific classes showed shifts, with increased use of SSRIs and opioids, and decreased use of broad-spectrum penicillins.
Conclusions:
- Central nervous system medications and GERD treatments saw increased prescribing in pediatric populations.
- A decline in the use of cough preparations and analgesics was observed in children and adolescents.
- These findings highlight evolving patterns in pediatric pharmacotherapy, emphasizing the need for ongoing surveillance.
Purpose:
To describe the prescribing trends of 17 therapeutic drug categories and the specific drug classes of systemic antibiotics, analgesics, and antidepressants in children and adolescents in the United Kingdom between 1998 and 2018.
Methods:
A population-based retrospective cohort study including children and adolescents aged 018 years. Overall and annual prescription rates per 10 000 person-years and corresponding 95% confidence intervals (CIs) were calculated. Rate ratios and 95% CIs were calculated to assess changes in prescription rates during the study period using Poisson regression.
Results:
Among 4 075 527 children and adolescents during the study period from 1998 to 2018, the prescribing rates increased by 15% for attention deficit hyperactivity disorder drugs (rate ratio: 1.15, 95% CI: 1.12-1.18), 14% for anxiolytics and hypnotics (rate ratio: 1.14, 95% CI: 1.13-1.16), and 8% for drugs for gastroesophageal reflux disease (GERD) (rate ratio: 1.08, 95% CI: 1.07-1.09). Prescribing rates decreased by 6% for cough preparations (rate ratio: 0.94, 95% CI: 0.92-0.95) and by 3% for analgesics (rate ratio: 0.97, 95% CI: 0.96-0.99). No meaningful changes were observed for systemic antibiotics (rate ratio: 1.02, 95% CI: 0.99-1.04). Among specific drug classes, prescribing rates decreased for broad-spectrum penicillins and cephalosporins, and they increased for selective serotonin reuptake inhibitors, opioids, and drugs for migraine.
Conclusions:
Between 1998 and 2018, the prescribing of centrally acting drugs and drugs for GERD increased among pediatric patients, whereas prescribing of cough preparations and analgesics declined in this population.
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