Stimulant Medication Use in Children: A 12-Year Perspective
Stimulant Medication Use in Children: A 12-Year Perspective
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DOI：
10.1176/appi.ajp.2011.11030387
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发表时间：
2012-02-01
影响因子：
17.7
通讯作者：
Vitiello, Benedetto
中科院分区：
文献类型：
--
作者：
Zuvekas, Samuel H.;Vitiello, Benedetto
目的：作者调查了1996-2008年间美国儿童ADHD的刺激性药物的使用情况，以确定年龄、性别、种族/民族、家庭收入和地理区域的趋势。方法：对美国18岁及以下儿童的治疗刺激性药物的使用情况进行分析。结果：据估计，2008年有3.5%(95%可信区间=3.0-4.1)的美国儿童接受了兴奋剂药物治疗，高于1996年的2.4%。在1996-2008年期间，兴奋剂使用量以3.4%的总体年增长率持续增长。在青少年中使用有所增加(年增长6.5%)，但在6至12岁的儿童中没有明显变化，在学龄前儿童中减少。男孩的使用量仍然高于女孩，西部地区的使用量一直低于美国其他地区。虽然家庭收入的差异随着时间的推移已经消失，但在种族/民族少数群体中，兴奋剂在ADHD治疗中的使用显著减少。结论：总体而言，自1996年以来，儿科兴奋剂的使用一直在缓慢但稳定地增加，这主要是由于青少年使用的更多。学龄前儿童的使用量仍然很低，而且随着时间的推移有所下降。与种族/民族背景和地理区域有关的重要差异仍然存在，因此表明美国社区治疗ADHD的方法存在很大的异质性。
Objective: The authors examined the utilization of stimulant medications for the treatment of ADHD in U.S. children during the period 1996-2008 to determine trends by age, sex, race/ethnicity, family income, and geographic region.Method: The 1996-2008 database of the Medical Expenditure Panel Survey, a nationally representative annual survey of U.S. households, was analyzed for therapeutic stimulant use in children age 18 and younger. The data for 1987 were also recalculated for reference.Results: An estimated 3.5% (95% confidence interval=3.0-4.1) of U.S. children received stimulant medication in 2008, up from 2.4% in 1996. Over the period 1996-2008, stimulant use increased consistently at an overall annual growth rate of 3.4%. Use increased in adolescents (annual growth, 6.5%), but it did not significantly change in 6- to 12-year-olds, and it decreased in preschoolers. Use remained higher in boys than in girls, and it remained consistently lower in the West than in other U.S. regions. While differences by family income have disappeared over time, use of stimulants in ADHD treatment is significantly lower in racial/ethnic minorities.Conclusions: Overall, pediatric stimulant use has been slowly but steadily increasing since 1996, primarily as a result of greater use in adolescents. Use in preschoolers remains low and has declined over time. Important variations related to racial/ethnic background and geographic region persist, thus indicating a substantial heterogeneity in the approach to the treatment of ADHD in U.S. communities.