Original Research

Methylphenidate and atomoxetine prescribing trends in children in the Western Cape Province of South Africa, 2005–2013

Liezl Joubert, Johanita R. Burger, Ilse Truter, Martie S. Lubbe, Marike Cockeran
Health SA Gesondheid | Vol 23 | a1084 | DOI: https://doi.org/10.4102/hsag.v23i0.1084 | © 2018 Liezl Joubert, Johanita R. Burger, Ilse Truter, Martie S. Lubbe, Marike Cockeran | This work is licensed under CC Attribution 4.0
Submitted: 26 January 2018 | Published: 31 July 2018

About the author(s)

Liezl Joubert, Medicine Usage in South Africa, Faculty of Health Sciences, North-West University, South Africa
Johanita R. Burger, Medicine Usage in South Africa, Faculty of Health Sciences, North-West University, South Africa
Ilse Truter, Drug Utilisation Research Unit, Faculty of Health Sciences, Nelson Mandela University, South Africa
Martie S. Lubbe, Medicine Usage in South Africa, Faculty of Health Sciences, North-West University, South Africa
Marike Cockeran, Medicine Usage in South Africa, Faculty of Health Sciences, North-West University, South Africa


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Abstract

Background: There is paucity of data on methylphenidate and atomoxetine prescribing patterns in South African children.

 

Aim: To describe the prescribing trends of these agents in children residing in the Western Cape Province.

 

Setting: South African private health sector.

 

Methods: Longitudinal drug utilisation study on medicine claims data from 2005–2013, focussing on the number of patients and prescriptions per patient.

 

Results: The total number of patients increased by 29.5% from 2005 to 2013. The majority were boys (male:female ratio, 3.5:1), and between the ages of > 6 and ≤12 years in 2005 and >12 and ≤18 years in 2013. More than 75% of patients received methylphenidate or atomoxetine in the City of Cape Town Metropolitan municipality. Prescriptions for methylphenidate and atomoxetine increased by 45.5% overall from 2005 to 2013 (p < 0.001), with that for methylphenidate and atomoxetine increasing by 36.0% and 314.5%, respectively. The average number of annual methylphenidate prescriptions per patient increased from 3.96 ± 2.92 (95% CI, 3.69–4.23) in 2005 to 4.38 ± 2.85 (95% CI, 4.14–4.61) in 2013 (Cohen’s d = 0.14) and for atomoxetine from 2.58 ± 1.86 (95% CI, 1.80–3.37) in 2005 to 4.85 ± 3.66 (95% CI, 3.84–5.86) in 2013 (Cohen’s d = 0.62).

 

Conclusion: Although the total number of patients and prescribing of methylphenidate and atomoxetine increased significantly from 2005 to 2013, a slight downward trend was observed in the mean number of prescriptions per patient per year from 2008 onwards. These prescribing patterns warrant further research.


Keywords

Western Cape Province; South Africa; children; adolescents; atomoxetine; methylphenidate; prescribing patterns

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