Parents report on stimulant-treated children in the Netherlands: initiation of treatment and follow-up care.
OBJECTIVE
The aim of this study was to describe current practices around initiation and follow-up care of stimulant treatment among stimulant-treated children in a nationwide survey among parents.


METHODS
A total of 115 pharmacies detected current stimulant users <16 years old in their pharmacy information system and sent parents a questionnaire regarding their child's stimulant treatment.


RESULTS
Parents returned 924 of 1,307 questionnaires (71%). The median age of the stimulant users was 10 years and 85% were boys. In all, 91% were diagnosed with attention-deficit/hyperactivity disorder (ADHD). In 77% of the cases, the child or parents received other therapies besides stimulants-21% received psychotropic co-medication, with melatonin (11%) and antipsychotics (7%) being mentioned most frequently. Stimulant use was primarily initiated by child psychiatrists (51%) and pediatricians (32%), but most children received repeat prescriptions from general practitioners (61%). Of these 924 children, 19% did not receive any follow-up care, and transfer of prescribing responsibility increased the risk of not receiving follow-up care. The 732 children (79%) who were monitored visited a physician approximately twice a year. During follow-up visits, pediatricians performed physical check ups significantly more often.


CONCLUSIONS
Stimulant treatment in The Netherlands is initiated mainly by specialists such as child psychiatrists and pediatricians. In the current study, follow-up care for stimulant-treated children in The Netherlands appeared to be poor, suggesting an urgent need for improvement.
Faber
Adrianne
A
Department of Social Pharmacy, Pharmacoepidemiology and Pharmacotherapy, Groningen University Institute for Drug Exploration, Groningen, The Netherlands. adrianne.faber@chello.nl
Kalverdijk
Luuk J
LJ
de Jong-van den Berg
Lolkje T W
LT
Hugtenburg
Jacqueline G
JG
Minderaa
Ruud B
RB
Tobi
Hilde
H
D000293:Adolescent; D000359:Aftercare / Q000706:statistics & numerical data; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000453:epidemiology; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D002648:Child; D003913:Dextroamphetamine / Q000627:therapeutic use*; D017723:Drug Utilization Review; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use*; D009426:Netherlands; D010348:Patient Care Team / Q000706:statistics & numerical data; D012017:Referral and Consultation / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
D000697:Central Nervous System Stimulants; D008774:Methylphenidate; D003913:Dextroamphetamine