Temporal trends of antidepressant utilization patterns in children and adolescents in Hong Kong: A 14-year population-based study with joinpoint regression analysis.

Autor: Lo HKY; Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong., Tong CCHY; Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong., Chan JKN; Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong., Kam CTK; Department of Psychiatry, Queen Mary Hospital, Hospital Authority, Hong Kong., Wong CSM; School of Public Health, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong., Cheng CPW; Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong., Ho C; Child and Adolescent Psychiatry Unit, Department of Psychiatry, Queen Mary Hospital, Hospital Authority, Hong Kong., Leung BMH; Child and Adolescent Psychiatry Unit, Department of Psychiatry, Queen Mary Hospital, Hospital Authority, Hong Kong., Wong WSH; Child and Adolescent Psychiatry Unit, Department of Psychiatry, Queen Mary Hospital, Hospital Authority, Hong Kong., Yu ZHS; Child and Adolescent Psychiatry Unit, Department of Psychiatry, Queen Mary Hospital, Hospital Authority, Hong Kong., Chang WC; Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, the University of Hong Kong, Hong Kong; State Key Laboratory of Brain and Cognitive Sciences, the University of Hong Kong, Hong Kong. Electronic address: changwc@hku.hk.
Jazyk: angličtina
Zdroj: Journal of affective disorders [J Affect Disord] 2024 Jan 01; Vol. 344, pp. 61-68. Date of Electronic Publication: 2023 Oct 11.
DOI: 10.1016/j.jad.2023.10.055
Abstrakt: Background: There is limited research on real-world antidepressant utilization patterns in children and adolescents, particularly in non-western countries. We aimed to examine temporal trends of antidepressant prescribing practice among Chinese children and adolescents in Hong Kong over 14-year period.
Methods: This population-based study identified 9566 patients aged 5-17 years who had redeemed at least one antidepressant prescription within 2005-2018, using data from health-record database of Hong Kong public healthcare services. We calculated annual prescription rates (per 1000 persons) for any antidepressant, antidepressant drug classes, and individual antidepressants. Joinpoint-regression analyses were performed to assess temporal antidepressant prescription trends, quantified by average annual-percent-change (AAPC), with 95 % confidence-intervals (CIs).
Results: Overall antidepressant prescription rate significantly increased over time (AAPC: 7.30 [95 % CI: 6.70-7.90]), from 3.883 in 2005 to 9.916 in 2018. The use of selective-serotonin-reuptake-inhibitors (SSRIs), serotonin-norepinephrine-reuptake-inhibitors (SNRIs), and other antidepressants significantly increased over 14 years, while tricyclic-antidepressants remained stable. SSRI represented the most commonly-prescribed drug class. Fluoxetine and sertraline constituted the two most frequently-prescribed individual antidepressants, while desvenlafaxine (AAPC: 55.68 [30.74-85.39]) and bupropion (AAPC: 35.28 [23.68-47.98]) exhibited the sharpest increase in prescription rates over the study period.
Limitations: Medication adherence could not be assessed and actual drug use may be overestimated.
Conclusions: Our results affirm a significant rising trend of antidepressant prescriptions among Chinese children and adolescents over time. All antidepressant drug-classes, except TCA, demonstrated significantly increased use, with SSRI being the most frequently-prescribed drug class. Future investigation should clarify indications, hence off-label use, of antidepressant initiation in this vulnerable population.
Competing Interests: Declaration of competing interest The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.
(Copyright © 2023 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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