Social Adversity and Regional Differences in Prescribing of ADHD Medication for School-Age Children

Publikation: Bidrag til tidsskriftTidsskriftartikelfagfællebedømt

Standard

Social Adversity and Regional Differences in Prescribing of ADHD Medication for School-Age Children. / Kildemoes, Helle Wallach; Skovgaard, Anne Mette; Thielen, Karsten; Pottegård, Anton; Mortensen, Laust Hvas.

I: Journal of Developmental and Behavioral Pediatrics, Bind 36, Nr. 5, 06.2015, s. 330-341.

Publikation: Bidrag til tidsskriftTidsskriftartikelfagfællebedømt

Harvard

Kildemoes, HW, Skovgaard, AM, Thielen, K, Pottegård, A & Mortensen, LH 2015, 'Social Adversity and Regional Differences in Prescribing of ADHD Medication for School-Age Children', Journal of Developmental and Behavioral Pediatrics, bind 36, nr. 5, s. 330-341. https://doi.org/10.1097/DBP.0000000000000170

APA

Kildemoes, H. W., Skovgaard, A. M., Thielen, K., Pottegård, A., & Mortensen, L. H. (2015). Social Adversity and Regional Differences in Prescribing of ADHD Medication for School-Age Children. Journal of Developmental and Behavioral Pediatrics, 36(5), 330-341. https://doi.org/10.1097/DBP.0000000000000170

Vancouver

Kildemoes HW, Skovgaard AM, Thielen K, Pottegård A, Mortensen LH. Social Adversity and Regional Differences in Prescribing of ADHD Medication for School-Age Children. Journal of Developmental and Behavioral Pediatrics. 2015 jun.;36(5):330-341. https://doi.org/10.1097/DBP.0000000000000170

Author

Kildemoes, Helle Wallach ; Skovgaard, Anne Mette ; Thielen, Karsten ; Pottegård, Anton ; Mortensen, Laust Hvas. / Social Adversity and Regional Differences in Prescribing of ADHD Medication for School-Age Children. I: Journal of Developmental and Behavioral Pediatrics. 2015 ; Bind 36, Nr. 5. s. 330-341.

Bibtex

@article{9274aaa662be4cbd82787fb5a539b490,
title = "Social Adversity and Regional Differences in Prescribing of ADHD Medication for School-Age Children",
abstract = "Objectives: To explore whether regional variations in the initiation of attention-deficit hyperactivity disorder (ADHD) medication among school-age children are explained by differences in sociodemographic composition and/or ADHD prescribing practice, especially in children who face social adversity (low parental education and single parenthood).Methods: A cohort of Danish school-age children (ages 5–17) without previous psychiatric conditions (N = 813,416) was followed during 2010–2011 for incident ADHD prescribing in the individual-level Danish registers. Register information was retrieved for both children and their parents. Regional differences were decomposed into contributions from differences in sociodemographic composition and in prescribing practices. Incidence rate ratios (IRR) with 95% confidence interval (CI) of ADHD prescribing were calculated using demographically standardized multivariable Poisson regression models.Results: Compared with the Capital, prescribing rates were significantly higher in regions North and Zealand (IRR, 1.19; 95% CI, 1.08–1.32 and 1.17; 1.08–1.28, respectively) and lower in South (IRR, 0.60; 95% CI, 0.54–0.66). After inclusion of the interaction term (region*social adversity), the multivariable analyses revealed a higher rate for the most disadvantaged children in North (IRR, 2.00; 95% CI, 1.51–2.66) and a lower rate in South (IRR, 0.47; 95% CI, 0.3–0.65). Prescribing rates were the highest for disadvantaged children in all regions, demonstrating the steepest social gradient in North and the smoothest in South. Demographic composition explained little of the variation: 3% for North and 13% for Zealand.Conclusions: Differences in sociodemographic composition explain little of regional variation in incident ADHD prescribing for children. However, large regional differences prevail in prescribing practices for children facing social adversity, indicating that local cultures shape the interpretation and handling of children with ADHD-like behaviors.",
author = "Kildemoes, {Helle Wallach} and Skovgaard, {Anne Mette} and Karsten Thielen and Anton Potteg{\aa}rd and Mortensen, {Laust Hvas}",
year = "2015",
month = jun,
doi = "10.1097/DBP.0000000000000170",
language = "English",
volume = "36",
pages = "330--341",
journal = "Journal of Developmental and Behavioral Pediatrics",
issn = "0196-206X",
publisher = "Lippincott Williams & Wilkins",
number = "5",

}

RIS

TY - JOUR

T1 - Social Adversity and Regional Differences in Prescribing of ADHD Medication for School-Age Children

AU - Kildemoes, Helle Wallach

AU - Skovgaard, Anne Mette

AU - Thielen, Karsten

AU - Pottegård, Anton

AU - Mortensen, Laust Hvas

PY - 2015/6

Y1 - 2015/6

N2 - Objectives: To explore whether regional variations in the initiation of attention-deficit hyperactivity disorder (ADHD) medication among school-age children are explained by differences in sociodemographic composition and/or ADHD prescribing practice, especially in children who face social adversity (low parental education and single parenthood).Methods: A cohort of Danish school-age children (ages 5–17) without previous psychiatric conditions (N = 813,416) was followed during 2010–2011 for incident ADHD prescribing in the individual-level Danish registers. Register information was retrieved for both children and their parents. Regional differences were decomposed into contributions from differences in sociodemographic composition and in prescribing practices. Incidence rate ratios (IRR) with 95% confidence interval (CI) of ADHD prescribing were calculated using demographically standardized multivariable Poisson regression models.Results: Compared with the Capital, prescribing rates were significantly higher in regions North and Zealand (IRR, 1.19; 95% CI, 1.08–1.32 and 1.17; 1.08–1.28, respectively) and lower in South (IRR, 0.60; 95% CI, 0.54–0.66). After inclusion of the interaction term (region*social adversity), the multivariable analyses revealed a higher rate for the most disadvantaged children in North (IRR, 2.00; 95% CI, 1.51–2.66) and a lower rate in South (IRR, 0.47; 95% CI, 0.3–0.65). Prescribing rates were the highest for disadvantaged children in all regions, demonstrating the steepest social gradient in North and the smoothest in South. Demographic composition explained little of the variation: 3% for North and 13% for Zealand.Conclusions: Differences in sociodemographic composition explain little of regional variation in incident ADHD prescribing for children. However, large regional differences prevail in prescribing practices for children facing social adversity, indicating that local cultures shape the interpretation and handling of children with ADHD-like behaviors.

AB - Objectives: To explore whether regional variations in the initiation of attention-deficit hyperactivity disorder (ADHD) medication among school-age children are explained by differences in sociodemographic composition and/or ADHD prescribing practice, especially in children who face social adversity (low parental education and single parenthood).Methods: A cohort of Danish school-age children (ages 5–17) without previous psychiatric conditions (N = 813,416) was followed during 2010–2011 for incident ADHD prescribing in the individual-level Danish registers. Register information was retrieved for both children and their parents. Regional differences were decomposed into contributions from differences in sociodemographic composition and in prescribing practices. Incidence rate ratios (IRR) with 95% confidence interval (CI) of ADHD prescribing were calculated using demographically standardized multivariable Poisson regression models.Results: Compared with the Capital, prescribing rates were significantly higher in regions North and Zealand (IRR, 1.19; 95% CI, 1.08–1.32 and 1.17; 1.08–1.28, respectively) and lower in South (IRR, 0.60; 95% CI, 0.54–0.66). After inclusion of the interaction term (region*social adversity), the multivariable analyses revealed a higher rate for the most disadvantaged children in North (IRR, 2.00; 95% CI, 1.51–2.66) and a lower rate in South (IRR, 0.47; 95% CI, 0.3–0.65). Prescribing rates were the highest for disadvantaged children in all regions, demonstrating the steepest social gradient in North and the smoothest in South. Demographic composition explained little of the variation: 3% for North and 13% for Zealand.Conclusions: Differences in sociodemographic composition explain little of regional variation in incident ADHD prescribing for children. However, large regional differences prevail in prescribing practices for children facing social adversity, indicating that local cultures shape the interpretation and handling of children with ADHD-like behaviors.

U2 - 10.1097/DBP.0000000000000170

DO - 10.1097/DBP.0000000000000170

M3 - Journal article

VL - 36

SP - 330

EP - 341

JO - Journal of Developmental and Behavioral Pediatrics

JF - Journal of Developmental and Behavioral Pediatrics

SN - 0196-206X

IS - 5

ER -

ID: 138185669