title: Long term trends in oral antidiabetic drug use among children and adolescents in the Netherlands.
abstract: OBJECTIVE
  The aim of the study was to document long term trends in oral antidiabetic drug (OAD) use among children and adolescents in the Netherlands.
  
  
  METHODS
  A population-based cohort study was conducted using the Dutch PHARMO Database Network. All patients younger than 20 years old with at least one OAD dispensing were identified. Age-adjusted and age-specific incidence (1999-2011) and prevalence (1998-2011) rates of OAD use were calculated. Trends over time were assessed using joinpoint regression software. A subset of PHARMO Database Network (including community pharmacy dispensing records linked to general practitioner data (OPD-GP database)) was used to assess indications for OADs.
  
  
  RESULTS
  In 2011, the overall age-adjusted incidence and prevalence rates of OAD use were 20.7/100 000 (95% CI 19.2, 22.1) person-years (PY) and 53.8/100 000 (95% CI 51.5, 56.1) persons, respectively. The average annual percentage change (AAPC) in the overall age-adjusted incidence rates from 1999 to 2011 was 18.9% (95% CI 4.5, 35.2). The incidence and prevalence rates of OAD use were higher among females and older age categories. The increases in rates of OAD use were mainly driven by metformin. For only 50% of the 98 patients in the OPD-GP database, indications for OAD prescriptions were reported with type 1 diabetes (n = 20), type 2 diabetes (n = 16), and overweight/obesity (n = 10).
  
  
  CONCLUSIONS
  Incidence and prevalence rates of OAD use in children and adolescents substantially increased in the Netherlands, especially among older age categories (10-14 and 15-19 years) and females. The main indications for use of OADs were type 1 and 2 diabetes and overweight/obesity.
authors: Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, the Netherlands.
authors: S
authors: S
authors: Fazeli Farsani
authors: Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, the Netherlands.
authors: P C
authors: PC
authors: Souverein
authors: PHARMO Institute for Drug Outcomes Research, Utrecht, the Netherlands.
authors: J A
authors: JA
authors: Overbeek
authors: Department of Paediatrics, St. Antonius Hospital, Nieuwegein, the Netherlands.
authors: M M J
authors: MM
authors: van der Vorst
authors: Department of Clinical Pharmacy, St. Antonius Hospital, Nieuwegein, the Netherlands.|Division of Pharmacology, Leiden Academic Centre for Drug Research, Leiden University, Leiden, the Netherlands.
authors: C A J
authors: CA
authors: Knibbe
authors: PHARMO Institute for Drug Outcomes Research, Utrecht, the Netherlands.|Department of Medical Informatics, Erasmus Medical Centre, Rotterdam, the Netherlands.
authors: R M C
authors: RM
authors: Herings
authors: Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, the Netherlands.
authors: A
authors: A
authors: de Boer
authors: Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, the Netherlands.
authors: A K
authors: AK
authors: Mantel-Teeuwisse
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016208:Databases, Factual; D017723:Drug Utilization Review / Q000639:trends*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007223:Infant; D008297:Male; D009426:Netherlands; D013997:Time Factors; D055815:Young Adult
chemical_list: D007004:Hypoglycemic Agents
keywords: children; incidence; oral antidiabetic; pattern; prevalence