title: Antipsychotic prescribing in youths: a French community-based study from 2006 to 2013.
abstract: The objectives were to explore in a community-based sample of persons aged 0-25 years: (1) trends in antipsychotic prescribing, (2) characteristics of the zone of residence associated with antipsychotic prescribing rates, and (3) the pattern of antipsychotic prescribing. The study was performed using reimbursement data from the French Insurance Healthcare system. Prescribing trends were investigated over the period 2006-2013. An ecological design was used to assess the impact of the socio-economical and health resource characteristics of the zone of residence (n = 96 administrative subdivisions of French territory) on antipsychotic prescribing rates. The pattern of antipsychotic prescribing was explored in a cohort of youths newly treated with antipsychotics. Over the period 2006-2013, antipsychotic dispensing rates were stable in persons aged 0-25 years (4.8 per 1,000 in 2006 and 4.9 per 1,000 in 2013). First-generation antipsychotic dispensing rates decreased from 3.1 to 2.6 per 1,000 (OR = 0.96, 95% CI 0.94-0.98), while second-generation antipsychotic dispensing rates increased from 2.7 to 3.4 per 1,000 (OR = 1.03, 95% CI 1.01-1.05). Antipsychotic prescribing rates were impacted by health resource characteristics of the zone of residence in children aged 10 years and under and by socio-economical characteristics in those aged 16-20 years. In all the age groups, antipsychotics were principally started by hospital practitioners (47%) and general practitioners (34%). The rates of psychostimulants concomitantly prescribed with antipsychotics were lower than 5%. In conclusion, rates of youths exposed to second-generation antipsychotics are still rising. The impact of environmental characteristics on antipsychotics prescribing and appropriateness of these prescriptions in youths should be further investigated.
authors.affiliation: Univ. Bordeaux, U657, 33000, Bordeaux, France. helene.verdoux@u-bordeaux.fr.|INSERM, U657, 33000, Bordeaux, France. helene.verdoux@u-bordeaux.fr.|Centre Hospitalier Charles Perrens, 121 rue de la Béchade, 33076, Bordeaux Cedex, France. helene.verdoux@u-bordeaux.fr.
authors.forename: Hélène
authors.initials: H
authors.lastname: Verdoux
authors.affiliation: Univ. Bordeaux, U657, 33000, Bordeaux, France.|INSERM, U657, 33000, Bordeaux, France.
authors.forename: Elodie
authors.initials: E
authors.lastname: Pambrun
authors.affiliation: Aix Marseille Université (Aix Marseille School of Economics-SESSTIM UMR 912, INSERM, IRD), Marseille, France.|ORS PACA (Observatoire régional de la santé, Provence-Alpes-Côte d'Azur), Marseille, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Cortaredona
authors.affiliation: Univ. Bordeaux, U657, 33000, Bordeaux, France.|INSERM, U657, 33000, Bordeaux, France.|Centre Hospitalier Charles Perrens, 121 rue de la Béchade, 33076, Bordeaux Cedex, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Tournier
authors.affiliation: Aix Marseille Université (Aix Marseille School of Economics-SESSTIM UMR 912, INSERM, IRD), Marseille, France.|ORS PACA (Observatoire régional de la santé, Provence-Alpes-Côte d'Azur), Marseille, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Verger
mesh_terms: D000293:Adolescent; D000367:Age Factors; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005260:Female; D005602:France; D006801:Humans; D007223:Infant; D008297:Male; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000453:epidemiology; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents
keywords: Adolescents; Antipsychotics; Children; Community characteristics; Prescribing trends