Abstract
BackgroundThe study aim was to examine the secular trends and regional variations in pharmacotherapy of children and adolescents with attention-deficit/hyperactivity disorder (ADHD) in Germany.MethodsWe used nationwide drug prescription data of outpatient care (2009 to 2016). The study population comprised patients aged between 5 and 14 years with the diagnoses “hyperkinetic disorders” (ICD-10 code F90) (e.g. n = 262,766 in 2016). The examined drugs were methylphenidate, amphetamines, atomoxetine and guanfacine.ResultsOverall, the proportion of patients received any prescription showed a decreasing trend over years (2010, 51%; 2016, 44%). The proportion of methylphenidate prescription was higher in Western than Eastern federal states. However, atomoxetine was more often prescribed in Eastern than Western federal states. The proportion of methylphenidate prescriptions issued by pediatric psychiatrists increased from 28% (2009) to 41% (2016).ConclusionA decreasing trend in use of pharmacotherapy may be explained by prescription restrictions issued by the Federal Joint Committee in recent years.
Highlights
The study aim was to examine the secular trends and regional variations in pharmacotherapy of children and adolescents with attention-deficit/hyperactivity disorder (ADHD) in Germany
In the current analysis we considered the anatomical therapeutic chemical (ATC) codes from the group N06B exclusively used for ADHD therapy (“psychostimulants, agents used for ADHD and nootropics”)
Study population The study population comprised children and adolescents aged between 5 and 14 years diagnosed with ADHD (n = 274,202 in 2009; n = 262,766 in 2016)
Summary
The study aim was to examine the secular trends and regional variations in pharmacotherapy of children and adolescents with attention-deficit/hyperactivity disorder (ADHD) in Germany. A recent population-based study in Germany showed a stagnating trend in the period between 2009 and 2016 [1]. Previous studies reported increasing trends in prescription of both stimulants and non-stimulants in Akmatov et al BMC Psychiatry (2021) 21:405 earlier years in Germany. The prescription prevalence of methylphenidate on the population level doubled from 0.54% in 2000 to 1.1% in 2007 among children and adolescents [7]. Due to an increasing trend in using stimulants the Federal Joint Committee (G-BA, “Gemeinsamer Bundesausschuss”) – the German regulatory agency for statutory health insurance – issued several prescription restrictions over the period of 2009 to 2014 [9]. Less is known about prescription patterns for other recently introduced stimulants, dexamfetamine and lisdexamfetamine and a non-stimulant guanfacine
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