PDF(Pubmed)
Abstract：
Attention-deficit/hyperactivity disorder (ADHD) is one of the most common pediatric neurobehavioral disorders in the U.S. Stimulants, classified as controlled substances, are commonly used for ADHD management. We conducted an analysis of real-world stimulants dispensing data to evaluate the pandemic\'s impact on young patients (≤ 26 years) in California.
Annual prevalence of patients on stimulants per capita across various California counties from 2019 and 2021 were analyzed and further compared across different years, sexes, and age groups. New patients initiating simulants therapy were also examined. A case study was conducted to determine the impact of socioeconomic status on patient prevalence within different quintiles in Los Angeles County using patient zip codes. Logistic regression analysis using R Project was employed to determine demographic factors associated with concurrent use of stimulants with other controlled substances.
There was a notable reduction in prevalence of patients ≤26 years old on stimulants during and after the pandemic per 100,000 people (777 in 2019; 743 in 2020; 751 in 2021). These decreases were more evident among the elementary and adolescent age groups. The most prevalent age group on stimulants were adolescents (12-17 years) irrespective of the pandemic. A significant rise in the number of female patients using stimulants was observed, increasing from 107,957 (35.2%) in 2019 to 121,241 (41.1%) in 2021. New patients initiating stimulants rose from 102,754 in 2020 to 106,660 in 2021, with 33.2% being young adults. In Los Angeles County, there was an increasing trend in patient prevalence from Q1 to Q5 income quintiles among patients ≥6 years. Consistently each year, the highest average income quintile exhibited the highest per capita prevalence. Age was associated with higher risk of concurrent use of benzodiazepines (OR, 1.198 [95% CI, 1.195-1.201], p < 0.0001) and opioids (OR, 1.132 [95% CI, 1.130-1.134], p < 0.0001) with stimulants.
Our study provides real-world information on dispensing of ADHD stimulants in California youth from 2019 to 2021. The results underscore the importance of optimizing evidence-based ADHD management in pediatric patients and young adults to mitigate disparities in the use of stimulants.
Annual prevalence of patients on stimulants per capita across various California counties from 2019 and 2021 were analyzed and further compared across different years, sexes, and age groups. New patients initiating simulants therapy were also examined. A case study was conducted to determine the impact of socioeconomic status on patient prevalence within different quintiles in Los Angeles County using patient zip codes. Logistic regression analysis using R Project was employed to determine demographic factors associated with concurrent use of stimulants with other controlled substances.
There was a notable reduction in prevalence of patients ≤26 years old on stimulants during and after the pandemic per 100,000 people (777 in 2019; 743 in 2020; 751 in 2021). These decreases were more evident among the elementary and adolescent age groups. The most prevalent age group on stimulants were adolescents (12-17 years) irrespective of the pandemic. A significant rise in the number of female patients using stimulants was observed, increasing from 107,957 (35.2%) in 2019 to 121,241 (41.1%) in 2021. New patients initiating stimulants rose from 102,754 in 2020 to 106,660 in 2021, with 33.2% being young adults. In Los Angeles County, there was an increasing trend in patient prevalence from Q1 to Q5 income quintiles among patients ≥6 years. Consistently each year, the highest average income quintile exhibited the highest per capita prevalence. Age was associated with higher risk of concurrent use of benzodiazepines (OR, 1.198 [95% CI, 1.195-1.201], p < 0.0001) and opioids (OR, 1.132 [95% CI, 1.130-1.134], p < 0.0001) with stimulants.
Our study provides real-world information on dispensing of ADHD stimulants in California youth from 2019 to 2021. The results underscore the importance of optimizing evidence-based ADHD management in pediatric patients and young adults to mitigate disparities in the use of stimulants.
摘要：
注意缺陷/多动障碍（ADHD）是美国兴奋剂中最常见的儿科神经行为障碍之一，归类为受控物质，通常用于ADHD管理。我们对现实世界中的兴奋剂分配数据进行了分析，以评估大流行对加利福尼亚州年轻患者（≤26岁）的影响。
■分析了2019年和2021年加州各县人均兴奋剂患者的年患病率，并进一步比较了不同年份。性别,和年龄组。还检查了开始模拟治疗的新患者。进行了案例研究，以使用患者邮政编码确定社会经济地位对洛杉矶县不同五分位数内患者患病率的影响。使用RProject进行Logistic回归分析，以确定与兴奋剂与其他受控物质同时使用相关的人口统计学因素。
■在大流行期间和之后，每100,000人中≤26岁的兴奋剂患者的患病率显着降低（2019年为777人；2020年为743人；2021年为751人）。这些下降在小学和青少年年龄组中更为明显。无论大流行如何，使用兴奋剂最普遍的年龄组是青少年（12-17岁）。观察到使用兴奋剂的女性患者数量显着增加，从2019年的107957（35.2%）增加到2021年的121241（41.1%）。新的兴奋剂患者从2020年的102,754人增加到2021年的106,660人，其中33.2％是年轻人。在洛杉矶县,在≥6年的患者中,从第1季度到第5季度的患者患病率呈增加趋势.始终如一地每年,平均收入最高的五分之一人口表现出最高的人均患病率。年龄与同时使用苯二氮卓类药物的风险较高相关（OR，1.198[95%CI，1.195-1.201]，p<0.0001)和阿片类药物(OR，1.132[95%CI，1.130-1.134]，p<0.0001）与兴奋剂。
■我们的研究提供了从2019年到2021年在加州青少年中分配多动症兴奋剂的真实信息。结果强调了优化儿科患者和年轻人基于证据的ADHD管理以减轻兴奋剂使用差异的重要性。
■分析了2019年和2021年加州各县人均兴奋剂患者的年患病率，并进一步比较了不同年份。性别,和年龄组。还检查了开始模拟治疗的新患者。进行了案例研究，以使用患者邮政编码确定社会经济地位对洛杉矶县不同五分位数内患者患病率的影响。使用RProject进行Logistic回归分析，以确定与兴奋剂与其他受控物质同时使用相关的人口统计学因素。
■在大流行期间和之后，每100,000人中≤26岁的兴奋剂患者的患病率显着降低（2019年为777人；2020年为743人；2021年为751人）。这些下降在小学和青少年年龄组中更为明显。无论大流行如何，使用兴奋剂最普遍的年龄组是青少年（12-17岁）。观察到使用兴奋剂的女性患者数量显着增加，从2019年的107957（35.2%）增加到2021年的121241（41.1%）。新的兴奋剂患者从2020年的102,754人增加到2021年的106,660人，其中33.2％是年轻人。在洛杉矶县,在≥6年的患者中,从第1季度到第5季度的患者患病率呈增加趋势.始终如一地每年,平均收入最高的五分之一人口表现出最高的人均患病率。年龄与同时使用苯二氮卓类药物的风险较高相关（OR，1.198[95%CI，1.195-1.201]，p<0.0001)和阿片类药物(OR，1.132[95%CI，1.130-1.134]，p<0.0001）与兴奋剂。
■我们的研究提供了从2019年到2021年在加州青少年中分配多动症兴奋剂的真实信息。结果强调了优化儿科患者和年轻人基于证据的ADHD管理以减轻兴奋剂使用差异的重要性。
