Stimulant prescribing for the treatment of ADHD in Western Australia: socioeconomic and remoteness differences.
OBJECTIVE
To identify whether the rate and average daily dose of stimulant prescribed for attention deficit hyperactivity disorder (ADHD) in Western Australia differed according to the geographical remoteness and socioeconomic status of the patient.


METHODS
Secondary analysis of population-based administrative pharmacy data from 2004, stratified by the Accessibility/Remoteness Index of Australia (ARIA+) categories and the Index of Relative Socio-Economic Disadvantage (IRSD) quintiles for WA (2001 Census).


METHODS
Rate ratios of stimulant prescription and mean average daily dose (in dex-equivalents) stratified by age (2-17, 18+ years), sex, ARIA+ category and IRSD quintile.


RESULTS
The rate of stimulant prescription was 2.3 to 5.3 times greater in major cities in WA compared with remote and very remote parts of the state. The association between socioeconomic disadvantage and the rate of stimulant prescription was highly variable. Adults with the least socioeconomic disadvantage were significantly more likely to receive stimulants compared with their most disadvantaged counterparts; however, the reverse association was seen with children. The average daily dose of stimulant prescribed did not vary greatly across remoteness or socioeconomic categories.


CONCLUSIONS
Remoteness and socioeconomic disadvantage are significantly associated with rate of stimulant prescription for ADHD in WA, but not associated with average daily dose of stimulant prescribed. Further research is needed to understand why considerable variation exists in the use of prescribed stimulants for ADHD.
Calver
Janine
J
Centre for Research on Ageing, Curtin University of Technology, Perth, WA, Australia. Janine.Calver@health.wa.gov.au
Preen
David
D
Bulsara
Max
M
Sanfilippo
Frank
F
D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000453:epidemiology; D000697:Central Nervous System Stimulants / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D012424:Rural Population / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014904:Western Australia / Q000453:epidemiology
D000697:Central Nervous System Stimulants