Melatonin dispensing and polypharmacy rates for New Zealand children with autism or attention deficit hyperactivity disorders: A nationwide pharmacoepidemiological study / Laurie K. MCLAY in Research in Autism Spectrum Disorders, 93 (May 2022)  

Public ISBD [article]  inResearch in Autism Spectrum Disorders > 93 (May 2022) . - 101948 Titre : Melatonin dispensing and polypharmacy rates for New Zealand children with autism or attention deficit hyperactivity disorders: A nationwide pharmacoepidemiological study Type de document : Texte imprimé et/ou numérique Auteurs : Laurie K. MCLAY, Auteur ; Nicholas J. BOWDEN, Auteur ; Matthew J. F. EGGLESTON, Auteur ; Hiran THABREW, Auteur ; Rhiannon BRAUND, Auteur ; Philip J. SCHLUTER, Auteur Article en page(s) : 101948 Langues : Anglais (eng) Mots-clés : Autism  Attention deficit hyperactivity disorder  Melatonin  Sleep  Polypharmacy Index. décimale : PER Périodiques Résumé : Background Chronic insomnia is common in children with autism and Attention Deficit Hyperactivity Disorder (ADHD). Melatonin is often used to treat childhood insomnia. However, it may interact with other medications being used to manage other symptoms. This pharmacoepidemiological study examined the rates of general and psychotropic polypharmacy among children with autism and/or ADHD, stratified by melatonin dispensing. The impact of sociodemographic and child characteristics on such dispensing was also examined. Method Linked national health and pharmaceutical administrative data for children aged 0?18 years in 2019 was utilized. Overall and melatonin dispensing stratified polypharmacy rates were calculated. Ordinal logistic regression models were employed to compare groups and adjust for confounders. Results Data were acquired for 10,209 children with autism (18.5% were dispensed melatonin), 5970 with ADHD (22.3% were dispensed melatonin), 2064 with autism and ADHD (29.9% were dispensed melatonin), and 1156,296 without a diagnosis of autism or ADHD (a control group; 0.5% dispensed melatonin). Relative to controls, rates of melatonin dispensing and polypharmacy were higher in children with autism and ADHD, and highest among those with both conditions. Children dispensed melatonin experienced the greatest rates of polypharmacy, especially if they had both autism and ADHD. Conclusions Children with autism and ADHD experience significant medication burden and potentially adverse interactions between psychotropic and sleep-related medication, raising important questions regarding their clinical care. En ligne : https://doi.org/10.1016/j.rasd.2022.101948 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=475 [article] Melatonin dispensing and polypharmacy rates for New Zealand children with autism or attention deficit hyperactivity disorders: A nationwide pharmacoepidemiological study [Texte imprimé et/ou numérique] / Laurie K. MCLAY, Auteur ; Nicholas J. BOWDEN, Auteur ; Matthew J. F. EGGLESTON, Auteur ; Hiran THABREW, Auteur ; Rhiannon BRAUND, Auteur ; Philip J. SCHLUTER, Auteur . - 101948. Langues : Anglais (eng) in Research in Autism Spectrum Disorders > 93 (May 2022) . - 101948 Mots-clés : Autism  Attention deficit hyperactivity disorder  Melatonin  Sleep  Polypharmacy Index. décimale : PER Périodiques Résumé : Background Chronic insomnia is common in children with autism and Attention Deficit Hyperactivity Disorder (ADHD). Melatonin is often used to treat childhood insomnia. However, it may interact with other medications being used to manage other symptoms. This pharmacoepidemiological study examined the rates of general and psychotropic polypharmacy among children with autism and/or ADHD, stratified by melatonin dispensing. The impact of sociodemographic and child characteristics on such dispensing was also examined. Method Linked national health and pharmaceutical administrative data for children aged 0?18 years in 2019 was utilized. Overall and melatonin dispensing stratified polypharmacy rates were calculated. Ordinal logistic regression models were employed to compare groups and adjust for confounders. Results Data were acquired for 10,209 children with autism (18.5% were dispensed melatonin), 5970 with ADHD (22.3% were dispensed melatonin), 2064 with autism and ADHD (29.9% were dispensed melatonin), and 1156,296 without a diagnosis of autism or ADHD (a control group; 0.5% dispensed melatonin). Relative to controls, rates of melatonin dispensing and polypharmacy were higher in children with autism and ADHD, and highest among those with both conditions. Children dispensed melatonin experienced the greatest rates of polypharmacy, especially if they had both autism and ADHD. Conclusions Children with autism and ADHD experience significant medication burden and potentially adverse interactions between psychotropic and sleep-related medication, raising important questions regarding their clinical care. En ligne : https://doi.org/10.1016/j.rasd.2022.101948 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=475

National prescribing rates and polypharmacy for children and young people in New Zealand with and without autism spectrum disorder / Nicholas J. BOWDEN in Research in Autism Spectrum Disorders, 78 (October 2020)  

Public ISBD [article]  inResearch in Autism Spectrum Disorders > 78 (October 2020) . - 101642 Titre : National prescribing rates and polypharmacy for children and young people in New Zealand with and without autism spectrum disorder Type de document : Texte imprimé et/ou numérique Auteurs : Nicholas J. BOWDEN, Auteur ; Hiran THABREW, Auteur ; Jesse KOKAUA, Auteur ; Rhiannon BRAUND, Auteur Article en page(s) : 101642 Langues : Anglais (eng) Mots-clés : Autism spectrum disorder  Children  Adolescents  Pharmacotherapy  Integrated Data Infrastructure  Polypharmacy Index. décimale : PER Périodiques Résumé : Background International data and guidance on prescribing for children and young people with autism spectrum disorder (ASD) are limited. National administrative datasets such as the New Zealand Integrated Data Infrastructure (IDI) may offer a cost-effective and sustainable way to monitor prescribing trends in the context of clinical and systemic change. Method Medication dispensing for New Zealand children and young people with ASD was explored using the IDI. Psychotropic and non-psychotropic medication dispensing rates, and rates of polypharmacy within a one-year period were examined. Comparisons of medication use were made to children and young people with another neurodevelopmental condition, attention deficit hyperactivity disorder (ADHD), and the general population. Results The vast majority (83 %) of children and young people with ASD were prescribed medication within a one-year period and they received a mean of four unique medications. High dispensing of antihistamine, asthma, gastrointestinal, and psychotropic medications was observed. Just over half (57 %) of those with ASD experienced polypharmacy of three or more medications, and 11 % of 10 or more. Medication dispensing rates were significantly higher among the ASD group compared to those with ADHD and the general population. Polypharmacy rates were higher among both the ASD and ADHD group compared to the general population. Conclusions It is clear that New Zealand children and young people with ASD experience a significant and disproportionate medication burden. Although further investigation is needed to fully understand underlying reasons and clinical implications, the IDI appears to be a valuable means of monitoring prescribing trends over time. En ligne : https://doi.org/10.1016/j.rasd.2020.101642 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=433 [article] National prescribing rates and polypharmacy for children and young people in New Zealand with and without autism spectrum disorder [Texte imprimé et/ou numérique] / Nicholas J. BOWDEN, Auteur ; Hiran THABREW, Auteur ; Jesse KOKAUA, Auteur ; Rhiannon BRAUND, Auteur . - 101642. Langues : Anglais (eng) in Research in Autism Spectrum Disorders > 78 (October 2020) . - 101642 Mots-clés : Autism spectrum disorder  Children  Adolescents  Pharmacotherapy  Integrated Data Infrastructure  Polypharmacy Index. décimale : PER Périodiques Résumé : Background International data and guidance on prescribing for children and young people with autism spectrum disorder (ASD) are limited. National administrative datasets such as the New Zealand Integrated Data Infrastructure (IDI) may offer a cost-effective and sustainable way to monitor prescribing trends in the context of clinical and systemic change. Method Medication dispensing for New Zealand children and young people with ASD was explored using the IDI. Psychotropic and non-psychotropic medication dispensing rates, and rates of polypharmacy within a one-year period were examined. Comparisons of medication use were made to children and young people with another neurodevelopmental condition, attention deficit hyperactivity disorder (ADHD), and the general population. Results The vast majority (83 %) of children and young people with ASD were prescribed medication within a one-year period and they received a mean of four unique medications. High dispensing of antihistamine, asthma, gastrointestinal, and psychotropic medications was observed. Just over half (57 %) of those with ASD experienced polypharmacy of three or more medications, and 11 % of 10 or more. Medication dispensing rates were significantly higher among the ASD group compared to those with ADHD and the general population. Polypharmacy rates were higher among both the ASD and ADHD group compared to the general population. Conclusions It is clear that New Zealand children and young people with ASD experience a significant and disproportionate medication burden. Although further investigation is needed to fully understand underlying reasons and clinical implications, the IDI appears to be a valuable means of monitoring prescribing trends over time. En ligne : https://doi.org/10.1016/j.rasd.2020.101642 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=433

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