Geographic variation and sociodemographic correlates of prescription psychotropic drug use among children and youth in Ontario, Canada: a population-based study

被引：5

作者：

Antoniou, Tony ^{[1
,2
,3
,4
]}

McCormack, Daniel ^{[2
]}

Kitchen, Sophie ^{[2
]}

Pajer, Kathleen ^{[5
,6
]}

Gardner, William ^{[2
,7
]}

Lunsky, Yona ^{[2
,8
,9
]}

Penner, Melanie ^{[10
,11
]}

Tadrous, Mina ^{[2
,12
]}

Mamdani, Muhammad ^{[1
,2
,12
,13
,14
,15
]}

Juurlink, David N. ^{[2
,11
,16
]}

Gomes, Tara ^{[1
,2
,12
,15
]}

机构：

[1] St Michaels Hosp, Li Ka Shing Knowledge Inst, Toronto, ON, Canada

[2] ICES, Toronto, ON, Canada

[3] Univ Toronto, Dept Family & Community Med, Toronto, ON, Canada

[4] St Michaels Hosp, Dept Family & Community Med, Toronto, ON, Canada

[5] Childrens Hosp Eastern Ontario Res Inst, Ottawa, ON, Canada

[6] Univ Ottawa, Dept Psychiat, Ottawa, ON, Canada

[7] Univ Ottawa, Sch Epidemiol & Publ Hlth, Ottawa, ON, Canada

[8] Azrieli Adult Neurodev Ctr, Ctr Addict & Mental Hlth, Toronto, ON, Canada

[9] Univ Toronto, Dept Psychiat, Toronto, ON, Canada

[10] Holland Bloorview Kids Rehabil Hosp, Bloorview Res Inst, Autism Res Ctr, Toronto, ON, Canada

[11] Univ Toronto, Dept Pediat, Toronto, ON, Canada

[12] Univ Toronto, Leslie Dan Fac Pharm, Toronto, ON, Canada

[13] Unity Hlth Toronto, Li Ka Shing Ctr Healthcare Analyt Res & Training, Toronto, ON, Canada

[14] Univ Toronto, Temerty Fac Med, Toronto, ON, Canada

[15] Univ Toronto, Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada

[16] Univ Toronto, Dept Med, Toronto, ON, Canada

来源：

BMC PUBLIC HEALTH | 2023年 / 23卷 / 01期

基金：

加拿大健康研究院;

关键词：

Child; Adolescent; Psychotropic drugs; Prescriptions; statistics & numerical data; Geographic variation; Small-area analysis; Socioeconomic factors; CLINICAL-PRACTICE GUIDELINE; MEDICATION USE; ANTIDEPRESSANT PRESCRIPTIONS; NATIONAL SAMPLE; YOUNG-PEOPLE; ADOLESCENTS; PATTERNS; TRENDS; PREVALENCE; DISORDER;

D O I：

10.1186/s12889-022-14677-6

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Background Population-based research examining geographic variability in psychotropic medication dispensing to children and youth and the sociodemographic correlates of such variation is lacking. Variation in psychotropic use could reflect disparities in access to non-pharmacologic interventions and identify potentially concerning use patterns.Methods We conducted a population-based study of all Ontario residents aged 0 to 24 years who were dispensed a benzodiazepine, stimulant, antipsychotic or antidepressant between January 1, 2018, and December 31, 2018. We conducted small-area variation analyses and identified determinants of dispensing using negative binomial generalized estimating equation models.Results The age- and sex-standardized rate of psychotropic dispensing to children and youth was 76.8 (range 41.7 to 144.4) prescriptions per 1000 population, with large variation in psychotropic dispensing across Ontario's census divisions. Males had higher antipsychotic [rate ratio (RR) 1.40; 95% confidence interval (CI) 1.36 to 1.44) and stimulant (RR 1.75; 95% CI 1.70 to 1.80) dispensing rates relative to females, with less use of benzodiazepines (RR 0.85; 95% CI 0.83 to 0.88) and antidepressants (RR 0.81; 95% CI 0.80 to 0.82). Lower antipsychotic dispensing was observed in the highest income neighbourhoods (RR 0.72; 95% CI 0.70 to 0.75) relative to the lowest. Benzodiazepine (RR 1.12; 95% CI 1.01 to 1.24) and stimulant (RR 1.11; 95% CI 1.01 to 1.23) dispensing increased with the density of mental health services in census divisions, whereas antipsychotic use decreased (RR 0.82; 95% CI 0.73 to 0.91). The regional density of child and adolescent psychiatrists and developmental pediatricians (RR 1.00; 95% CI 0.99 to 1.01) was not associated with psychotropic dispensing.Conclusion We found significant variation in psychotropic dispensing among young Ontarians. Targeted investment in regions with long wait times for publicly-funded non-pharmacological interventions and novel collaborative service models may minimize variability and promote best practices in using psychotropics among children and youth.

引用

页数：12

共 66 条

[1]

[Anonymous], J HOPK ACG SYST

[2]

[Anonymous], 2016, 2016 Census Catalogue no. 98-316-X2016001

[3]

[Anonymous], 2017, Focus on Geography Series, 2016 Census

[4]

Appleby J, VARIATIONS HLTH CARE

[5] Interprovincial Variation in Antipsychotic and Antidepressant Prescriptions Dispensed in the Canadian Pediatric Population [J].