[Methylphenidate prescriptions in the city of Cologne: overrepresentation of privately insured patients. Results of an analysis based on prescription data].
BACKGROUND
Attention-deficit/hyperactivity disorder (ADHD) is a chronic psychiatric disorder which most commonly affects children and adolescents. Treatment with methylphenidate (MPH) entails a dependency risk as MPH is a psychotropic drug. In Germany, according to pharmaco-epidemiological studies based on figures provided by the general health insurance scheme, MPH prescriptions have increased 40-fold over the past decade.


OBJECTIVE
We aimed to investigate MPH prescriptions issued by medical practitioners in the city of Cologne with a special focus on prescription practices and the proportion of MPH prescriptions issued for privately insured patients.


METHODS
This is a descriptive study. The database consisted of all registered MPH prescriptions during the first two quarters of 2003 and included 2729 prescriptions issued by hospital and practice-based medical practitioners.


RESULTS
23% of all MPH prescriptions were issued on private prescriptions, indicating an overrepresentation of privately insured patients who generally make up about 10% of all insured persons in Germany. There was a high frequency of once-only prescriptions: 28% of all prescriptions fell into this category. In addition, prescribed daily doses were often lower or higher than age-specific recommended mean daily doses.


CONCLUSIONS
The study provided evidence of inappropriate care patterns concerning MPH. A marked socio-economic gradient exists with regard to MPH prescriptions.
Bessou
H
H
AG 3 Epidemiologie & International Public Health, Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Germany. hebessou@gmx.de
Zeeb
H
H
Puteanus
U
U
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D002947:Cities / Q000453:epidemiology; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use*; D017149:Private Sector / Q000706:statistics & numerical data*; D012042:Registries
D008774:Methylphenidate