American Kids Getting Fewer Prescription Drugs: Study

Antibiotic use is down, but ADHD and asthma prescriptions went up

Monday, June 18, 2012

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Medicines and Children

MONDAY, June 18 (HealthDay News) -- New research shows that the number of prescriptions written for children has dropped by 7 percent in recent years.
Between 2002 and 2010, notable decreases occurred in antibiotic, cough/cold, allergy, pain and depression prescriptions, according to the study, which was conducted by the U.S. Food and Drug Administration. At the same time, there was a rise in the number of asthma, attention-deficit hyperactivity disorder (ADHD) and contraceptive prescriptions.
"Approximately 263 million prescriptions were dispensed to the pediatric population in 2010 -- 7 percent lower than the number of prescriptions dispensed in 2002," the study authors said, adding that the number of prescriptions written for children dropped by 2.4 million each year between 2002 and 2010.
During that time, however, the number of prescriptions written for adults increased by 22 percent, according to the study.
The findings were released online June 18 and are scheduled to appear in the July print edition of the journal Pediatrics.
The top 10 prescribed drugs for children 17 and under in 2010 included antibiotics, asthma medications and the pain reliever ibuprofen. Antibiotics accounted for approximately one-quarter of all prescriptions written between 2002 and 2010, according to the study.
By 2010, however, the number of antibiotic prescriptions had decreased by 14 percent.
"This could potentially be good news. The antibiotic numbers are consistent with the efforts to decrease the use of antibiotics for upper respiratory infections," said Dr. Kenneth Bromberg, chairman of pediatrics at the Brooklyn Hospital Center in New York City.
He noted, however, that this particular study wasn't designed to tease out the reasons behind a change in medication use, only to determine whether a change occurred.
Still, he said, "It's likely that this represents some of the efforts to cut down on antibiotic use, and this will help to decrease the risk of antibiotic resistance."
The volume of allergy-medication prescriptions also decreased significantly (61 percent), but much of that decrease may be because many allergy medications went from prescription-only to being available over the counter during the study period.
The number of prescriptions written for cough and cold medication dropped by 42 percent during the study. The authors suggest that this may be due to a public-health advisory in 2008 that warned against using such medications in children under 2.
Prescriptions for pain medications declined by 14 percent, and the number of prescriptions for depression drugs dropped by 5 percent.
Dr. Victor Fornari, director of the division of child and adolescent psychiatry at North Shore-LIJ Health System in New Hyde Park, N.Y., said the decrease in depression-medication prescriptions may have something to do with the black box warnings that were added to the drugs, which described an increased risk of suicide.
Not all classes of medications were prescribed less often. The number of prescriptions for ADHD medications increased by 46 percent, according to the study. Part of that increase likely is due to an increase in the number of children being diagnosed with ADHD. In 2002, 4.4 million children were estimated to have the disorder. By 2010, that number was 5 million, according to the study.
Even with the increase in prescriptions, Fornari said ADHD still is being underdiagnosed and undertreated.
"With medication, the outcomes can be dramatic improvement in school performance and behavior," he said.
Another class of medications for which prescriptions increased dramatically was contraceptives. The number of prescriptions written increased by 93 percent, according to the study. The authors pointed out, however, that other research, done by the U.S. Centers for Disease Control and Prevention, hasn't shown an increase in the use of birth control pills.
Bromberg said one possible explanation for this disparity stems from the study itself. The researchers looked for the number of prescriptions written, not how many individuals received a prescription. So it may be that females on birth control are staying on the drug for longer periods of time, which would increase the number of prescriptions written.
The study also found that the number of prescriptions for asthma medications increased by 14 percent. The authors didn't theorize as to what might be behind this increase.

SOURCES: Kenneth Bromberg, M.D., chairman, pediatrics, Brooklyn Hospital Center, New York City; Victor Formari, M.D., director, division of child and adolescent psychiatry, North Shore-LIJ Health System, New Hyde Park, N.Y.; July 2012 Pediatrics

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