Yes, America’s tweenies more than doubled their use of type-2 diabetes medications between 2002 and 2005, with girls between 10 and 14 years of age showing a 166 percent increase, according to the
Saint Louis University School of Medicine and
Express Scripts, which presented the data this morning at the
American Public Health Association meeting in Washington DC. The academics and their PBM counterparts speculate that obesity is the reason for the increase, given its connection to Type 2 diabetes.
The finding is included in a study of chronic meds used in children between 5 to 19 years old, including treatments for diabetes, blood pressure, cholesterol, asthma and depression medications. “Across every chronic medication class we examined over this four year period of time, children’s use increased, with varying patterns of growth across males and females and age groups,†says Emily Cox, senior director of research at Express Scripts, in a statement e-mailed to us.
For example, the number of teenage boys between 15 and 19 years old who used a blood pressure drug increased by 15.4 percent, while the number of females in the age group taking the drugs, called antihypertensives, declined by 1.6 percent. On the other hand, the number of teenage girls between 15 and 19 years old taking an antidepressant increased by 6.8 percent, but use among teenage boys in the same age bracked declined slightly.
This increase in antidepressant use among 15 to 19 year old girls contrasted with decreases for boys and girls 5 to 9 years old, and boys 10 to 19 years old. It also occurred despite a FDA warnings regarding anti-depressant use by children. Among all children, the prevalence of antidepressant use had been increasing prior to the advisory after which it decreased. You can read the complete poster presentation here.
With asthma, children ages 5 to 9 accounted for the largest increase in the use of meds among the three age groups at 67.3 percent, compared to 38.8 percent for the 10 to 14 age group and 34.7 percent for the 15 to 19 age group. “This may be explained by concerns over long-term side effects of these medications in children and/or greater physician office visits, and therefore greater likelihood of prescribing,†says Donna Halloran, assistant professor of pediatrics at Saint Louis University School of Medicine.
“Overall, these patterns could reflect changing prescribing behaviors by physicians (anti-hypertensives), increases in the risk factors for chronic diseases (type-2 antidiabetics, antihyperlipidemics), increased office visit rates and therefore screening rates – particularly for females – or trends toward greater use of drug therapy as the preferred mode of treating children with chronic conditions,†says Sharon Homan, professor of community health, Saint Louis University School of Public Health.
5 Comments
This pretty much complements the discussion yesterday that began with discussion of prescribing PPIs for infants.
One of the sad facts about the history of significant regulatory reform (which the recently past FDA bill was not) is that it takes a disaster that kills or injures kids- elixir of sulfanilamide, thalidomide, etc. - before anything happens.
Is this another signal from the iceberg waiting for the Titanic? Genuine question.
Hank,
Well put. Its been well known for some time now, that blood pressure meds are used off-label for children w/mood disorders, and its not uncommon for Psychiatrists to prescribe so called "cocktails", and its a shame that we see these so called cocktails being given to infants and toddlers at an alarming rate.
Hank,
There are at least two issues going here. In one corner, you have the acid reflux meds, cold meds, and possibly antidepressants--meds for which there is some evidence of that prescribing and use of the meds in children exceeds the actual problem. While some argue this is due to the favorite demon--evil pharma companies--the issue can likely be attributed in part to parents who would rather have a pill do their job for them.
On the other side, you have the increase in prescribing of diabetes and asthma meds--and possibly the antidepressants (yes, I place that in both categories, as there is evidence of it fitting in both). In these cases, you have a legitimate increase in the prevalence of the condition for which the drugs are designed to treat. Diabetes is on the rise, in large part, because kids refuse to shut their pie hole, and parents are unwilling to enforce some discipline--or the evil fast food/snack food companies are controlling their minds with their commercials featuring clowns and cartoon characters, depending on whom you wish to believe.
The rise in asthma is a tricky one. Are environmental factors to blame? If so, which? Is it survival of the fittest in reverse (people with asthma, who would have died 100 years ago before getting the chance to reproduce are now, thanks to meds, living long enough to produce offspring, and thus pass it down)? I don't know.
But the overprescribing vs actual increase in condition are different issues, with different solutions, and that should be recognized before lumping them all together into one category.
Agree with your distinction, James, and there are many more one could mention.
The wider point is that it takes only one significant iceberg to take out a Titanic. So if only one drug or class of drugs can be shown to be overprescribed and overpromoted, in the presence of deliberately undisclosed or minimized risk factors (for which it would be hard to blame parents), and we lose a lot of kids or young adults as a result, head for the lifeboat.
[...] Ed Silverman created an interesting post today on Tweenies Are Taking More Chronic Meds.Here’s a short outline:The finding is included in a study of chronic meds used in children between 5 to 19 years old, including treatments for diabetes, utilization patterns for blood pressure, cholesterol, asthma and depression medications were also examined … [...]