Use of sleep medications in hospitalized pediatric patients
Use of sleep medications in hospitalized pediatric patients
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DOI：
10.1542/peds.2006-2773
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发表时间：
2007-06-01
期刊：
影响因子：
8
通讯作者：
Byars, Kelly C.
中科院分区：
文献类型：
--
作者：
Meltzer, Lisa J.;Mindell, Jodi A.;Byars, Kelly C.
Objective.对住院儿童睡眠的药物知之甚少。本研究的目的是（1）确定接受睡眠障碍药物治疗的住院儿童的百分比，（2）确定睡眠困难的处方药物，（3）检查与住院期间处方药物相关的医疗和人口统计学变量。在2004年随机选择的26天内，对3家儿科医院的所有住院患者进行了病历审查。收集了9440例患者的人口统计学、医学和药物治疗数据。样本中54.5%为男性，平均年龄为7.0岁，63%为白色。近19%的患者至少有1种精神病诊断。总体而言，6.0%的所有住院儿童（3%的所有医学住院儿童，不包括精神病诊断的儿童）处方了睡眠药物，抗组胺药是最常见的处方药物（36.6%），其次是苯二氮卓类药物（9.4%）;催眠药是最不常见的处方药物（2.2%）。在睡眠药物处方的频率和医院之间使用的药物类型以及年龄，住院时间和儿童出院服务方面都存在显着差异。有精神病诊断的儿童更有可能接受睡眠药物治疗，22%接受精神病服务的儿童接受睡眠相关药物治疗。大约3%到6%的儿童在医院接受了广泛的睡眠药物治疗。处方做法因医院、医疗服务、儿童年龄和诊断而异。这项研究的结果表明，住院儿童，特别是精神病诊断儿童的睡眠药物。然而，鉴于美国食品和药物管理局既没有批准的儿童睡眠药物，也没有关于其使用的临床共识指南，因此显然需要临床试验、实践指南和额外的研究。
Objective. Little is known about the medications prescribed for sleep in hospitalized children. The aims of this study were to (1) determine the percentage of hospitalized children who receive medication for sleep disturbances, (2) determine what medications are prescribed for sleep difficulties, and (3) examine medical and demographic variables related to medications prescribed during hospitalization.Patients and Methods. A chart review was conducted for all inpatients at 3 pediatric hospitals across 26 randomly selected days in 2004. Demographic, medical, and medication data were collected on 9440 patients. The sample was 54.5% male, had a mean age of 7.0 years, and was 63% white. Almost 19% of the patients had at least 1 psychiatric diagnosis.Results. Overall, 6.0% of all hospitalized children (3% of all medically hospitalized children, excluding children with a psychiatric diagnosis) were prescribed medications for sleep, with antihistamines the most frequently prescribed medication (36.6%), followed by benzodiazepines (9.4%); hypnotic agents were the least frequently prescribed (2.2%). Significant differences were found in both the frequency of sleep- medication prescriptions and the types of medications used across hospitals, as well as for age, length of hospitalization, and service that the child was discharged from. Children with a psychiatric diagnosis were more likely to receive a sleep medication, with 22% of children on a psychiatric service receiving a sleep- related medication.Conclusions. Approximately 3% to 6% of children are treated pharmacologically with a broad array of sleep medications in hospital settings. Prescription practices vary by hospital, medical service, child age, and diagnosis. The results from this study indicate that medications are being prescribed for sleep in hospitalized children, especially in children with psychiatric diagnoses. However, given that there are neither Food and Drug Administration - approved sleep medications for children nor clinical consensus guidelines regarding their use, clinical trials, practice guidelines, and additional research are clearly needed.