Examining Trends in Antipsychotic Prescribing to Children and Adolescents: Insights from England

A noteworthy study conducted by Radojčić et al. (2023), published in The Lancet Psychiatry, offers comprehensive insights into the increasing trend of prescribing antipsychotics to children and adolescents in England. The research presents data over two decades, from 2000 to 2019, providing a crucial perspective on antipsychotic use, indicating likely indications, and revealing an important need for continued monitoring.

Methodology: Leveraging Clinical Coding and Large Scale Datasets

This study demonstrates the importance of clinical coding and the usage of large scale datasets in healthcare research. The researchers used a large primary care database, the Clinical Practice Research Datalink (CPRD) Aurum database, involving children and adolescents aged between 3–18 years, registered in England.

Through clinical codes, they developed an algorithm to identify the most likely indications associated with the first antipsychotic prescription for each participant. This use of clinical codes is a powerful tool in investigating healthcare trends, enhancing understanding and providing a robust data analysis foundation.

Findings: Increasing Antipsychotic Prescriptions Over Time

According to the study, the annual period prevalence of antipsychotic prescriptions has doubled over the 20-year period, from 0.057% in 2000 to 0.105% in 2019. Furthermore, atypical antipsychotics constituted a significant 92.7% of the prescriptions, while typical antipsychotics represented 7.3%.

The most common indications linked to the first identified antipsychotic prescriptions were autism spectrum disorder (12.7%), non-affective psychosis (8.6%), anxiety disorders (7.5%), ADHD (7.1%), depression (6.4%), and conduct disorders (6.1%).

Rising Antipsychotic Prescriptions: A Cause for Concern?

Radojčić et al.’s (2023) study concludes that the increase in antipsychotic prescriptions over two decades results from repeated prescriptions to the same individuals and an increase in new prescriptions. However, they rightly highlight the need for continued surveillance of antipsychotic use trends and a better understanding of long-term antipsychotic safety, especially in children and adolescents.

This points towards a broader implication for the healthcare industry and society – the necessity of balancing appropriate and potentially life-improving treatments with the need to guard against potential misuse or overuse. Clinical coding, and its use in research such as this, is key to understanding these trends, thereby enabling healthcare professionals to make informed decisions about treatment protocols.

Conclusion: The Pivotal Role of Clinical Coding in Monitoring Health Trends

The research by Radojčić et al. (2023) underscores the importance of robust clinical coding and how it can be employed to monitor healthcare trends. Accurate and comprehensive clinical coding not only provides a holistic picture of prescribing patterns but also forms the basis for devising better interventions, guidelines, and policies. This study is a strong reminder that in the evolving landscape of healthcare, the role of clinical coding in research and practice is more significant than ever.

Sources

Radojčić, M.R., Pierce, M., Hope, H., Senior, M., Taxiarchi, V.P., Trefan, L., Swift, E., & Abel, K.M. (2023). Trends in antipsychotic prescribing to children and adolescents in England: cohort study using 2000–19 primary care data. The Lancet Psychiatry, 10(2), 75-76. https://doi.org/10.1016/S2215-0366(22)00404-7

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