H Bessou1, H Zeeb, U Puteanus. 1. AG 3 Epidemiologie & International Public Health, Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Germany. hebessou@gmx.de
Abstract
BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is a chronic psychiatric disorder which most commonly affects children and adolescents. Treatment with methylphenidate (MPH) entails a dependency risk as MPH is a psychotropic drug. In Germany, according to pharmaco-epidemiological studies based on figures provided by the general health insurance scheme, MPH prescriptions have increased 40-fold over the past decade. OBJECTIVE: We aimed to investigate MPH prescriptions issued by medical practitioners in the city of Cologne with a special focus on prescription practices and the proportion of MPH prescriptions issued for privately insured patients. METHOD: This is a descriptive study. The database consisted of all registered MPH prescriptions during the first two quarters of 2003 and included 2729 prescriptions issued by hospital and practice-based medical practitioners. RESULTS: 23% of all MPH prescriptions were issued on private prescriptions, indicating an overrepresentation of privately insured patients who generally make up about 10% of all insured persons in Germany. There was a high frequency of once-only prescriptions: 28% of all prescriptions fell into this category. In addition, prescribed daily doses were often lower or higher than age-specific recommended mean daily doses. CONCLUSION: The study provided evidence of inappropriate care patterns concerning MPH. A marked socio-economic gradient exists with regard to MPH prescriptions.
BACKGROUND:Attention-deficit/hyperactivity disorder (ADHD) is a chronic psychiatric disorder which most commonly affects children and adolescents. Treatment with methylphenidate (MPH) entails a dependency risk as MPH is a psychotropic drug. In Germany, according to pharmaco-epidemiological studies based on figures provided by the general health insurance scheme, MPH prescriptions have increased 40-fold over the past decade. OBJECTIVE: We aimed to investigate MPH prescriptions issued by medical practitioners in the city of Cologne with a special focus on prescription practices and the proportion of MPH prescriptions issued for privately insured patients. METHOD: This is a descriptive study. The database consisted of all registered MPH prescriptions during the first two quarters of 2003 and included 2729 prescriptions issued by hospital and practice-based medical practitioners. RESULTS: 23% of all MPH prescriptions were issued on private prescriptions, indicating an overrepresentation of privately insured patients who generally make up about 10% of all insured persons in Germany. There was a high frequency of once-only prescriptions: 28% of all prescriptions fell into this category. In addition, prescribed daily doses were often lower or higher than age-specific recommended mean daily doses. CONCLUSION: The study provided evidence of inappropriate care patterns concerning MPH. A marked socio-economic gradient exists with regard to MPH prescriptions.
Authors: Angelina Mueller; Olga A Sawicki; Moritz Philipp Günther; Anastasiya Glushan; Claudia Witte; Renate Klaaßen-Mielke; Ferdinand M Gerlach; Martin Beyer; Kateryna Karimova Journal: Eur J Gen Pract Date: 2022-12 Impact factor: 3.636