The Pharmacoepidemiology of Selective Serotonin Reuptake Inhibitors for Children and Adolescents in Canada from 2005 to 2009: A Database Analysis

Lam, Darren; Gorman, Daniel A.; Patten, Scott B.; Pringsheim, Tamara

doi:10.1007/s40272-013-0014-8

Cited by 29 publications

(31 citation statements)

References 36 publications

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“…The data have been used previously to evaluate prescribing trends. [10][11][12] We requested further information on data collection; however, IMS Brogan does not release details regarding which pharmacies contribute to their database. Data for the same period were available from both sources and were compared to evaluate consistency of the findings.…”

Section: Data Collectionmentioning

confidence: 99%

Time trends in intracranial bleeding associated with direct oral anticoagulants: a 5-year cohort study

et al. 2015

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Section: Data Collectionmentioning

confidence: 99%

Time trends in intracranial bleeding associated with direct oral anticoagulants: a 5-year cohort study

et al. 2015

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“…Consequently, the sustained high use of antipsychotics observed in this study raises concerns, especially in view of recent recommendations cautioning against the use of these drugs for the treatment of non‐psychotic disorders and the demonstrated effectiveness of behavioural non‐pharmacological treatments, such as behaviour modification . The moderate decrease in use of SSRIs, the most commonly prescribed class of antidepressants, between 1999 and 2008 may be explained by reports of the risk of suicide and suicidal ideation among young users, as well as safety advisories issued during this time by regulators in countries such as Canada, the United States and the United Kingdom …”

Section: Discussionmentioning

confidence: 99%

“…In an aim to advance medication safety for children, an understanding of paediatric prescribing trends is required to identify the type and prevalence of medications prescribed, particularly those that are associated with high‐risk adverse events. To date, most studies on prescribing trends in children have focused on the inpatient setting or on specific drug categories, such as antipsychotics, antidepressants and medications used to treat attention‐deficit/hyperactivity disorder (ADHD) . These studies have revealed important changes in paediatric prescribing over time; however, most reflect a narrow examination of specific drug classes, producing a gap in understanding overall prescribing trends.…”

Section: Introductionmentioning

confidence: 99%

A population-based study of prescribing trends in a potentially vulnerable paediatric population from 1999 to 2012

Sears

Elms

Whitehead

et al. 2019

International Journal of Pharmacy Practice

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Objectives There is a limited understanding of paediatric medication prescribing trends and patterns, thus poorly positioning decision‐makers to identify quality and safety concerns related to medication use. The objective of this study was to determine overall medication prescribing trends and patterns among children receiving Ontario Drug Benefits over a thirteen‐year period in the province of Ontario, Canada. Methods Administrative health databases housed within the Institute for Clinical Evaluative Sciences (ICES), Ontario, Canada, were used to identify outpatient prescriptions dispensed from 1999 to 2012 through a publicly funded programme to children ≤18 years of age. Medications were classified according to the American Hospital Formulary Service Pharmacologic‐Therapeutic Classification system. Descriptive statistics were used to summarize prescribing patterns. Key findings This study identified 457 037 children who were dispensed a new prescription between 1999 and 2012. About 56% received their first prescription before 6.5 years of age, and 85% of the children in this study were from families who received social assistance. The most commonly prescribed drugs were antiinfectives (56.1%). Prescriptions for several central nervous system agents, including antipsychotics and agents for attention‐deficit/hyperactivity disorder, increased across the study period. Changes in prescribing patterns within opioids, hormones and autonomic agents were noted. The results suggest that historically, prescribing trends have shifted with public policy, pharmaceutical marketing and diagnostic patterns, thus identifying them as a possible tool to measure the impact of policydriven practice changes. Anti‐infective prescribing increased markedly with the global H1N1 pandemic. Pharmaceutical marketing, formulary decisions and diagnostic trends may affect the prescribing of ADHD medications globally. The prescribing of codeine‐containing products and medroxyprogesterone appeared to fluctuate in response to important publications in the medical literature, and the use of epinephrine syringes increased after public policy changes in the province of Ontario. The steady rise in the use of medications whose long‐term effects in children are unknown, such as antipsychotics and proton pump inhibitors, identifies areas in need of future research. Conclusions This study presents the first overview of Canadian prescribing trends for children, the majority of which are of low socioeconomic status and represent a potentially vulnerable population. Our analysis suggests that future research is required to determine whether prescribing trends could be used as indicators of policy effectiveness, pharmacovigilance and diagnostic trends.

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“…The risk of suicidal behavior at the early "activatory" stage of treatment [62] requires close monitoring, though suicidal tendencies are also high at the remission stage because of patients' low stress resistance, especially when they lack psychological support. In connection with these methodological limitations, data on suicidal tendencies require a balanced approach and obligatory modifi cations for subpopulations consisting of children and adolescents [63], particularly as prescription of SSRI (escitalopram) to children and adolescents becomes more frequent [64].…”

mentioning

confidence: 99%

Evidence-Based Selection and Use of Antidepressants in Psychiatric Practice

Любов

Ignatenko

2016

Neurosci Behav Physi

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Depressive disorders (DD) are serious psychological diseases, which are widespread, of early onset, with a risk of chronicization, frequent comorbidities, including alcohol abuse, cardiovascular diseases, suicidal tendencies, and aggressive behavior, along with decreases in patients' quality of life, all of which result in DD imposing a severe burden on society [1-3] and making assessment of the resource-sparing potential from the medical and social perspectives important [4][5][6]. Thus, in 2002, when the total number of cases needing assistance was 20-30 times smaller, the total medical costs of DD in the capital's psychoneurological clinics (PNC) accounted for 0.02% of the gross regional product of Moscow; social losses constituted 90% of the burden of DD, emphasizing the importance of optimizing the treatment of this type of mental pathology [7].The burden of DD is exacerbated by the insuffi cient effi cacy of psychopharmacotherapy even in countries with outstanding systems for standardized psychiatric care [4,[8][9][10]. No more than 50-60% of those needing treatment receive it, including severe cases [2,8,11]; the average treatment delay is three years [11]. Krasnov et al. [12] found that of 9988 patients attending reginal polyclinics, DD was present in 30%, though only 10% were receiving minimal courses of SSRI. The literature also contains data [4,13] showing that 70-80% of antidepressants were prescribed by inadequately trained general practitioners.Most patients receive inadequate treatment [2,14]. Patients attending PNC are generally (>60%) treated with subtherapeutic doses mainly of fi rst-generation tricyclic antidepressants (TCA) for less than three months, combined with sedative neuroleptics and tranquillizers on a constant basis; the better the provision of the psychiatric institution with medications, the more intricate the scheme of pharmacotherapy (sometimes including 3-5 drugs as 3-4 daily doses, without consideration of their half-elimination periods), which leads to an increase in the risk of undesirable effects, which elevates treatment costs without enhancing effi cacy [4,8]. The costs of second-line agents for the treatment of DD are greater than those for antidepressants. Archaic and complex patterns of antidepressant therapy generate additional stigmatization of psychiatric care, such that patients reject it. It is not by chance that 20% of those attending consultations for DD return to the PNC within a year [4,8]. The Russian standard (draft) for the treatment of DD in PNC and hospital conditions, discussing current poor practice, evoked a number of justifi able comments on the Russian Society of Depressive disorders (DD) have a high risk of recurrence and involve impairments to patients' daily and social functioning and quality of life; these factors result in a high socioeconomic burden. Optimization of antidepressant use on the basis of the risk:benefi t ratio and evidence-based resource-sparing potential is important for lightening of the load of DD, along with targeted psychosoci...

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The Pharmacoepidemiology of Selective Serotonin Reuptake Inhibitors for Children and Adolescents in Canada from 2005 to 2009: A Database Analysis

Cited by 29 publications

References 36 publications

Time trends in intracranial bleeding associated with direct oral anticoagulants: a 5-year cohort study

Time trends in intracranial bleeding associated with direct oral anticoagulants: a 5-year cohort study

A population-based study of prescribing trends in a potentially vulnerable paediatric population from 1999 to 2012

Evidence-Based Selection and Use of Antidepressants in Psychiatric Practice

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