TY - JOUR
T1 - Dispensing of psychotropic medications to Australian children and adolescents before and during the COVID-19 pandemic, 2013–2021
T2 - a retrospective cohort study
AU - Wood, Stephen J.
AU - Ilomäki, Jenni
AU - Gould, Jacqueline
AU - Tan, George S.Q.
AU - Raven, Melissa
AU - Jureidini, Jon N.
AU - Grzeskowiak, Luke E.
PY - 2023/7
Y1 - 2023/7
N2 - Objective: To determine longitudinal patterns of dispensing of antidepressant, anxiolytic, antipsychotic, psychostimulant, and hypnotic/sedative medications to children and adolescents in Australia during 2013–2021. Design: Retrospective cohort study; analysis of 10% random sample of Pharmaceutical Benefits Scheme (PBS) dispensing data. Participants, setting: People aged 18 years or younger dispensed PBS-subsidised psychotropic medications in Australia, 2013–2021. Main outcome measures: Population prevalence of dispensing of psychotropic medications to children and adolescents, by psychotropic class, gender, and age group (0–6, 7–12, 13–18 years). Results: The overall prevalence of psychotropic dispensing to children and adolescents was 33.8 per 1000 boys and 25.2 per 1000 girls in 2013, and 60.0 per 1000 boys and 48.3 per 1000 girls in 2021. The prevalence of psychotropic polypharmacy was 5.4 per 1000 boys and 3.7 per 1000 girls in 2013, and 10.4 per 1000 boys and 8.3 per 1000 girls in 2021. Prevalent dispensing during 2021 was highest for psychostimulants (boys, 44.0 per 1000; girls, 17.4 per 1000) and antidepressants (boys, 20.4 per 1000; girls, 33.8 per 1000). During 2021, the prevalence of dispensing was higher than predicted by extrapolation of 2013–2019 data for many classes, including antidepressants (boys: +6.1%; 95% CI, 1.1–11.1%; girls: +22.2%; 95% CI, 17.4–26.9%), and psychostimulants (boys: +14.5%; 95% CI, 8.0–21.1%; girls: +27.7%; 95% CI, 18.9–36.6%). The increases were greatest for girls aged 13–18 years (antidepressants: +20.3%; 95% CI, 16.9–23.7%; psychostimulants: +39.0%; 95% CI, 27.9–50.0%). Conclusions: The prevalence of both psychotropic dispensing and psychotropic polypharmacy for children and adolescents were twice as high in 2021 as in 2013. The reasons and appropriateness of the marked increases in psychotropic dispensing during the COVID-19 pandemic, particularly to adolescent girls, should be investigated.
AB - Objective: To determine longitudinal patterns of dispensing of antidepressant, anxiolytic, antipsychotic, psychostimulant, and hypnotic/sedative medications to children and adolescents in Australia during 2013–2021. Design: Retrospective cohort study; analysis of 10% random sample of Pharmaceutical Benefits Scheme (PBS) dispensing data. Participants, setting: People aged 18 years or younger dispensed PBS-subsidised psychotropic medications in Australia, 2013–2021. Main outcome measures: Population prevalence of dispensing of psychotropic medications to children and adolescents, by psychotropic class, gender, and age group (0–6, 7–12, 13–18 years). Results: The overall prevalence of psychotropic dispensing to children and adolescents was 33.8 per 1000 boys and 25.2 per 1000 girls in 2013, and 60.0 per 1000 boys and 48.3 per 1000 girls in 2021. The prevalence of psychotropic polypharmacy was 5.4 per 1000 boys and 3.7 per 1000 girls in 2013, and 10.4 per 1000 boys and 8.3 per 1000 girls in 2021. Prevalent dispensing during 2021 was highest for psychostimulants (boys, 44.0 per 1000; girls, 17.4 per 1000) and antidepressants (boys, 20.4 per 1000; girls, 33.8 per 1000). During 2021, the prevalence of dispensing was higher than predicted by extrapolation of 2013–2019 data for many classes, including antidepressants (boys: +6.1%; 95% CI, 1.1–11.1%; girls: +22.2%; 95% CI, 17.4–26.9%), and psychostimulants (boys: +14.5%; 95% CI, 8.0–21.1%; girls: +27.7%; 95% CI, 18.9–36.6%). The increases were greatest for girls aged 13–18 years (antidepressants: +20.3%; 95% CI, 16.9–23.7%; psychostimulants: +39.0%; 95% CI, 27.9–50.0%). Conclusions: The prevalence of both psychotropic dispensing and psychotropic polypharmacy for children and adolescents were twice as high in 2021 as in 2013. The reasons and appropriateness of the marked increases in psychotropic dispensing during the COVID-19 pandemic, particularly to adolescent girls, should be investigated.
KW - Child psychiatry
KW - COVID-19
KW - Pediatrics
KW - Pharmacoepidemiology
KW - Prescribing
KW - Psychotropic drugs
UR - http://www.scopus.com/inward/record.url?scp=85159115914&partnerID=8YFLogxK
U2 - 10.5694/mja2.51948
DO - 10.5694/mja2.51948
M3 - Article
AN - SCOPUS:85159115914
SN - 0025-729X
VL - 219
SP - 18
EP - 25
JO - Medical Journal of Australia
JF - Medical Journal of Australia
IS - 1
ER -
