title: Prescribing of psychostimulant medications for attention deficit hyperactivity disorder in children: differences between clinical specialties.
abstract: OBJECTIVE
  To examine differences in psychostimulant prescribing between paediatricians and child/adolescent psychiatrists for treating children with attention deficit hyperactivity disorder (ADHD) in Western Australia.
  
  
  METHODS
  Using whole-population prescribing data, logistic and linear regressions were used to model the number of children (aged 2-17 years) treated with psychostimulants between August 2003 and December 2004 for ADHD and medication dose prescribed by clinical specialty, controlling for age, sex, body weight, and other medication use.
  
  
  METHODS
  Mean number of patients treated by specialty; associations between prescriber specialty and patient characteristics; associations between stimulant dose and patient characteristics and prescriber specialty.
  
  
  RESULTS
  54 paediatricians and 23 child/adolescent psychiatrists prescribed stimulant medications for children with ADHD. The mean number of patients treated (per prescriber) was 159.8 (range, 1-1977) for paediatricians and 34.3 (range, 1-166) for psychiatrists. Boys were 32% more likely to be treated with stimulants by paediatricians (P = 0.002). Psychiatrists were 2.9 times (95% CI, 2.4-3.3; P < 0.001) more likely than paediatricians to treat patients with multiple psychotropic medications. When controlled for all other factors, psychiatrists prescribed higher stimulant doses (4.5 mg/day greater; 95% CI, 2.0-7.0 mg/day; P < 0.001) than paediatricians.
  
  
  CONCLUSIONS
  Treatment of children with stimulant medicines for ADHD differed between clinical specialties. Paediatricians treated more patients per prescriber, a greater proportion of boys, and a younger age demographic, but relied less on combined psychotropic pharmacotherapy and prescribed lower stimulant doses than psychiatrists.
authors.affiliation: School of Population Health, University of Western Australia, Perth, WA, Australia. david.preen@uwa.edu.au
authors.forename: David B
authors.initials: DB
authors.lastname: Preen
authors.forename: Janine
authors.initials: J
authors.lastname: Calver
authors.forename: Frank M
authors.initials: FM
authors.lastname: Sanfilippo
authors.forename: Max
authors.initials: M
authors.lastname: Bulsara
authors.forename: C D'Arcy J
authors.initials: CD
authors.lastname: Holman
mesh_terms: D000293:Adolescent; D000296:Adolescent Psychiatry; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D001315:Australia; D002648:Child; D002665:Child Psychiatry; D002675:Child, Preschool; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D006213:Hallucinogens / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D010372:Pediatrics
chemical_list: D006213:Hallucinogens