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Per Hove Thomsen

Trends in Off-Label Prescribing of Sedatives, Hypnotics and Antidepressants among Children and Adolescents - A Danish, Nationwide Register-Based Study

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Trends in Off-Label Prescribing of Sedatives, Hypnotics and Antidepressants among Children and Adolescents - A Danish, Nationwide Register-Based Study. / Nielsen, Eva Skovslund; Rasmussen, Lotte; Poulsen, Maja Hellfritzsch; Thomsen, Per Hove; Nørgaard, Mette; Laursen, Torben.

I: Basic & Clinical Pharmacology & Toxicology, Bind 120, Nr. 4, 04.2017, s. 360-367.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

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@article{e1715f6f1ae7468583f158880228a3dd,
title = "Trends in Off-Label Prescribing of Sedatives, Hypnotics and Antidepressants among Children and Adolescents - A Danish, Nationwide Register-Based Study",
abstract = "In recent years, psychotropic drug use among children and adolescents in Europe and USA has increased. However, the majority of psychotropic drugs are not formally approved for use in children and adolescents, and consequently, use is often off-label. The objectives were to describe time trends in off-label prescribing rates and the most commonly used types of psychotropic drugs by age and gender in Danish children and adolescents. Using the Register of Medicinal Product Statistics, we identified all prescriptions for sedatives, hypnotics and antidepressants filled for children and adolescents in 2006-2012. Information on diagnoses was obtained from the Danish National Registry of Patients and allowed classification of prescriptions as either on- or off-label. We identified 186,831 prescriptions filled for 29,851 children and adolescents: 88.0% of these were classified as off-label. During 2006-2012, off-label rates for sedatives and hypnotics increased significantly, except for prescriptions for girls aged 15-17 years [range 24.1-98.2% (girls), 31.9% to 99.0% (boys)]. In the same period, the number of registered melatonin prescriptions (all off-label) increased expansively. For antidepressants, we found decreasing trends in off-label rates over time [range 94.5-65.6% (girls), 93.8-71.2% (boys)]. Off-label prescribing of psychotropic drugs to Danish children and adolescents is common. Off-label rates for sedatives and hypnotics increased in the period of 2006-2012, whereas off-label rates for antidepressants declined. Off-label rates might be underestimated and should be considered a conservative estimate.",
keywords = "DRUG-USE, PEDIATRIC WARDS, PSYCHOTROPIC MEDICATIONS, LEGISLATION, COUNTRIES, MELATONIN, PATTERNS, ISSUES, COHORT, HEALTH, Melatonin/administration & dosage, Off-Label Use/statistics & numerical data, Age Factors, Humans, Child, Preschool, Drug Utilization Review/trends, Infant, Male, Registries/statistics & numerical data, Antidepressive Agents/administration & dosage, Female, Child, Health Records, Personal, Hypnotics and Sedatives/administration & dosage, Adolescent, Sex Factors, Denmark",
author = "Nielsen, {Eva Skovslund} and Lotte Rasmussen and Poulsen, {Maja Hellfritzsch} and Thomsen, {Per Hove} and Mette N{\o}rgaard and Torben Laursen",
note = "{\textcopyright} 2016 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).",
year = "2017",
month = apr,
doi = "10.1111/bcpt.12706",
language = "English",
volume = "120",
pages = "360--367",
journal = "Basic & Clinical Pharmacology & Toxicology",
issn = "1742-7835",
publisher = "Wiley-Blackwell Publishing Ltd.",
number = "4",

}

RIS

TY - JOUR

T1 - Trends in Off-Label Prescribing of Sedatives, Hypnotics and Antidepressants among Children and Adolescents - A Danish, Nationwide Register-Based Study

AU - Nielsen, Eva Skovslund

AU - Rasmussen, Lotte

AU - Poulsen, Maja Hellfritzsch

AU - Thomsen, Per Hove

AU - Nørgaard, Mette

AU - Laursen, Torben

N1 - © 2016 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

PY - 2017/4

Y1 - 2017/4

N2 - In recent years, psychotropic drug use among children and adolescents in Europe and USA has increased. However, the majority of psychotropic drugs are not formally approved for use in children and adolescents, and consequently, use is often off-label. The objectives were to describe time trends in off-label prescribing rates and the most commonly used types of psychotropic drugs by age and gender in Danish children and adolescents. Using the Register of Medicinal Product Statistics, we identified all prescriptions for sedatives, hypnotics and antidepressants filled for children and adolescents in 2006-2012. Information on diagnoses was obtained from the Danish National Registry of Patients and allowed classification of prescriptions as either on- or off-label. We identified 186,831 prescriptions filled for 29,851 children and adolescents: 88.0% of these were classified as off-label. During 2006-2012, off-label rates for sedatives and hypnotics increased significantly, except for prescriptions for girls aged 15-17 years [range 24.1-98.2% (girls), 31.9% to 99.0% (boys)]. In the same period, the number of registered melatonin prescriptions (all off-label) increased expansively. For antidepressants, we found decreasing trends in off-label rates over time [range 94.5-65.6% (girls), 93.8-71.2% (boys)]. Off-label prescribing of psychotropic drugs to Danish children and adolescents is common. Off-label rates for sedatives and hypnotics increased in the period of 2006-2012, whereas off-label rates for antidepressants declined. Off-label rates might be underestimated and should be considered a conservative estimate.

AB - In recent years, psychotropic drug use among children and adolescents in Europe and USA has increased. However, the majority of psychotropic drugs are not formally approved for use in children and adolescents, and consequently, use is often off-label. The objectives were to describe time trends in off-label prescribing rates and the most commonly used types of psychotropic drugs by age and gender in Danish children and adolescents. Using the Register of Medicinal Product Statistics, we identified all prescriptions for sedatives, hypnotics and antidepressants filled for children and adolescents in 2006-2012. Information on diagnoses was obtained from the Danish National Registry of Patients and allowed classification of prescriptions as either on- or off-label. We identified 186,831 prescriptions filled for 29,851 children and adolescents: 88.0% of these were classified as off-label. During 2006-2012, off-label rates for sedatives and hypnotics increased significantly, except for prescriptions for girls aged 15-17 years [range 24.1-98.2% (girls), 31.9% to 99.0% (boys)]. In the same period, the number of registered melatonin prescriptions (all off-label) increased expansively. For antidepressants, we found decreasing trends in off-label rates over time [range 94.5-65.6% (girls), 93.8-71.2% (boys)]. Off-label prescribing of psychotropic drugs to Danish children and adolescents is common. Off-label rates for sedatives and hypnotics increased in the period of 2006-2012, whereas off-label rates for antidepressants declined. Off-label rates might be underestimated and should be considered a conservative estimate.

KW - DRUG-USE

KW - PEDIATRIC WARDS

KW - PSYCHOTROPIC MEDICATIONS

KW - LEGISLATION

KW - COUNTRIES

KW - MELATONIN

KW - PATTERNS

KW - ISSUES

KW - COHORT

KW - HEALTH

KW - Melatonin/administration & dosage

KW - Off-Label Use/statistics & numerical data

KW - Age Factors

KW - Humans

KW - Child, Preschool

KW - Drug Utilization Review/trends

KW - Infant

KW - Male

KW - Registries/statistics & numerical data

KW - Antidepressive Agents/administration & dosage

KW - Female

KW - Child

KW - Health Records, Personal

KW - Hypnotics and Sedatives/administration & dosage

KW - Adolescent

KW - Sex Factors

KW - Denmark

U2 - 10.1111/bcpt.12706

DO - 10.1111/bcpt.12706

M3 - Journal article

C2 - 27860286

VL - 120

SP - 360

EP - 367

JO - Basic & Clinical Pharmacology & Toxicology

JF - Basic & Clinical Pharmacology & Toxicology

SN - 1742-7835

IS - 4

ER -