Der Einsatz von Methylphenidat im Kindesalter: Analyse des Verordnungsverhaltens auf der Basis von Routinedaten der gesetzlichen Krankenkassen zu Arzneimittelverordungen

Schmidt-Troschke, Stefan; Ostermann, Thomas; Melcher, D. H.; Schuster, R.; Erben, C. M.; Matthiessen, Peter F.

doi:10.1055/s-2004-813322

Cited by 29 publications

(6 citation statements)

References 7 publications

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“…A lower MPH treatment prevalence of 1.1% was also reported from Hesse in 2007, with an estimate of 1.7% for boys and 0.4% for girls under the age of 18 [2]. These lower prevalence estimates in Mecklenburg-West Pomerania and Hesse may indicate regional variations in MPH treatment in Germany [8]. In our study, treatment prevalence increased steadily from age 6 to age 11, which was also observed in the study from Hesse [2].…”

Section: Discussionmentioning

confidence: 89%

“…For Germany, MPH treatment prevalence was reported in two regional [2,8] and one national study [6], each based on data from a single health insurance company.…”

Section: Discussionmentioning

confidence: 99%

“…Another study based on data from the Federal State Mecklenburg-West Pomerania reported a total MPH treatment prevalence of 1.4% in 0- to 15-year-old children in 2001 [8]. A lower MPH treatment prevalence of 1.1% was also reported from Hesse in 2007, with an estimate of 1.7% for boys and 0.4% for girls under the age of 18 [2].…”

Section: Discussionmentioning

confidence: 99%

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Comorbidities in ADHD children treated with methylphenidate: a database study

et al. 2013

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BackgroundMethylphenidate (MPH) is the most common drug treatment of attention deficit / hyperactivity disorder (ADHD) in children. Treatment with MPH is contraindicated in the presence of certain psychiatric, cerebro- and cardiovascular conditions. We assessed MPH treatment prevalence and incidence and the frequency of comorbid conditions related to these contraindications in new MPH users compared to a control group without ADHD and ADHD medication.MethodsWe used health care data for the years 2004 to 2006 from the German Pharmacoepidemiological Research Database (GePaRD) which includes about 18% of the German population. MPH treatment prevalence and incidence was assessed based on at least one MPH prescription in the given year. In MPH users, the prevalence of psychiatric and other comorbidities was assessed in the quarter of the first MPH prescription and the three preceding quarters, whereas in controls it was assessed in the earliest four quarters of continuous insurance time starting at 01.01.2004 or the start of insurance if this was later. Differences in the presence of comorbid diagnoses between MPH users and controls were tested by logistic regression.ResultsIn 2005, 1.5% of all children and adolescents aged 3 to 17 years (2.3% of males and 0.6% of females) received MPH in Germany. The proportion of children with a record of a psychiatric comorbidity in any of the nine ICD categories of diagnoses was substantially higher in new MPH users (83%) compared to controls (20%). Cerebro- and cardiovascular comorbidities were rare in general. Still, among new MPH users, 2% of males and females had a diagnosis of a pre-existing cardiovascular disorder but only 1.2% of controls.ConclusionsBesides MPH treatment prevalence we first publish age-specific incidence rates for Germany. A high proportion of children who were started on MPH had a record of a psychiatric comorbidity preceding the first prescription. Cerebro- and cardiovascular conditions were rare in the studied age range, but still higher among children who received MPH than in the control group. Results show that in a substantial subgroup of patients, comorbidities require a thorough weighting of possible risks of MPH medication against the risks of untreated ADHD.

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Section: Discussionmentioning

confidence: 89%

“…For Germany, MPH treatment prevalence was reported in two regional [2,8] and one national study [6], each based on data from a single health insurance company.…”

Section: Discussionmentioning

confidence: 99%

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Comorbidities in ADHD children treated with methylphenidate: a database study

et al. 2013

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“…Prescription data from statutory health insurance (SHI) providers in Germany show a comparable trend 9. The drug prescription report describes a more-than-fivefold increase in prescriptions from 10 million DDDs (defined daily doses) in 1999 to 53 million DDDs in 2008 10.…”

Section: Introductionmentioning

confidence: 99%

Prevalence, determinants and spectrum of attention-deficit hyperactivity disorder (ADHD) medication of children and adolescents in Germany: results of the German Health Interview and Examination Survey (KiGGS)

et al. 2012

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ObjectiveTo investigate the prevalence, determinants and spectrum of attention-deficit hyperactivity disorder (ADHD) medication and its associations with socioeconomic status (SES), health-related behaviour and living conditions.DesignObservational cross-sectional study.SettingGermany.ParticipantsRepresentative population-based sample of non-institutionalised youth aged between 0 and 17 years (n=17 450) and examined between 2003 and 2006.Main outcome measurePrevalence and spectrum of ADHD medication (Anatomical Therapeutic Chemical (ATC) code N04BA) measured by standardised computer-assisted personal interview (CAPI) on drug use.ResultsThe overall prevalence of ADHD medication (stimulants including atomoxetine) was 0.9% (95% CI 0.7% to 1.1%). Boys used these drugs (1.5%, 1.2% to 1.8%) five times more than girls 0.3% (0.2% to 0.5%). The highest prevalence rates were for boys aged 6–10 years (2.3%, 1.7% to 3.1%S) and 11–13 (2.7%, 2.0% to 3.7%). Boys from families with no immigration background used ADHD medication almost 6 times as frequently as boys with an immigration background (1.7% vs 0.3%). Multivariate analysis (binary logistic regression) showed boys (OR 5.16, 95% CI 3.15 to 8.47), 11-year-olds to 13-year-olds (2.24, 1.28 to 3.49), children in large cities (2.18, 1.13 to 4.22), children with no immigration background (3.06, 1.34 to 6.99), and children with only a good (vs excellent) parent-rated health status (1.91, 1.18 to 3.08) being more likely to be using ADHD medication. A visit to the doctor in the last month or last quarter was associated with a higher probability for ADHD medication (3.18, 1.29 to 7.95 and 3.59, 1.45 to 8.90, respectively).ConclusionsResults show prevalence rates of ADHD medication use for the German child and adolescent population that are considerably lower than published prevalence rates from the USA, but comparable with those of western European and Scandinavian countries. Lower use rates in rural versus urban regions may point to differential healthcare access. The inverse association of ADHD medication use with immigration status suggests potentially restricted access to healthcare services for immigrants or may reflect culture-specific differences in attitudes towards symptoms of ADHD.

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“…These concern primarily delays in social, cognitive, and emotional functions, which manifest as symptoms such as difficulties in sleeping and lack of concentration. 1 A study by Schlack et al 2 shows the prevalence of ADHD to be around 5%, with boys affected about four times more often than girls are. While treatment with Ritalin (methylphenidate) is on the rise, 1 the use of body-oriented methods in the treatment of ADHD has not been sufficiently studied.…”

Section: Introductionmentioning

confidence: 99%