title: The variation of psychopharmacological prescription rates for people with autism spectrum disorder (ASD) in 30 countries.
abstract: There is significant variation in prescriptions among countries in clinical practice for the treatment of comorbidities associated with autism spectrum disorder (ASD). It has been suggested that many people with mental health disorders in low-/middle-income countries do not receive adequate treatment. Hence, this study investigated psychopharmacological treatment patterns for ASD comorbidities in 30 countries and the association between country's income and prescription rates. The IMS Prescribing Insights database was used to investigate prescription patterns for ASD comorbidity treatment from 2007 to 2012. Data were obtained from 30 countries in continents of Europe, Asia, Oceania, Central America, South America, and Africa. The gross domestic product (GDP) per capita was used as a proxy for each country's income. Spearman correlation was used to examine the association between prescription rate and GDP per capita. The highest prescription rates were found in Western Europe (3.89-36.36/10,000) while the lowest prescription rates were found in Asian countries, such as Turkey, Indonesia, Saudi Arabia, and Pakistan (0.04-0.82/10,000). The most commonly prescribed drug for ASD comorbidity treatment in most of the countries was risperidone, but antidepressants and antiepileptic drugs were also frequently prescribed. There was a significant positive correlation between GDP per capita and prescription rate (Spearman ρ = 0.60; P = 0.0011; 95% confidence interval 0.27-0.81), that is, the higher the GDP per capita, the higher the prescription rate. There are marked international differences in prescription rates, and this is partially accounted by economic factors. Future research should combine more data for ASD comorbidity treatment to explore the disparity of psychopharmacological treatment between countries.
authors.affiliation: Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, SAR, China.
authors.forename: Angel Y S
authors.initials: AY
authors.lastname: Wong
authors.forename: Yingfen
authors.initials: Y
authors.lastname: Hsia
authors.forename: Esther W
authors.initials: EW
authors.lastname: Chan
authors.forename: Declan G M
authors.initials: DG
authors.lastname: Murphy
authors.forename: Emily
authors.initials: E
authors.lastname: Simonoff
authors.forename: Jan K
authors.initials: JK
authors.lastname: Buitelaar
authors.forename: Ian C K
authors.initials: IC
authors.lastname: Wong
mesh_terms: D000349:Africa; D001208:Asia; D002489:Central America; D002659:Child Development Disorders, Pervasive / Q000453:epidemiology*; D015897:Comorbidity; D062313:Databases, Pharmaceutical / Q000706:statistics & numerical data*; D005060:Europe; D059066:Gross Domestic Product / Q000706:statistics & numerical data; D006801:Humans; D007182:Income; D038622:Internationality; D001523:Mental Disorders / Q000188:drug therapy* / Q000453:epidemiology; D044349:Oceania; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000706:statistics & numerical data*; D011600:Psychopharmacology; D012959:Socioeconomic Factors; D013020:South America
keywords: Gross Domestic Product; Multinational study; Psychopharmacology; epidemiology