The number of children on medication for chronic illnesses in the United States went up between 2002 and 2005 across a range of diseases, with a doubling of medication for type 2 diabetes, according to a new study.

The study was the work of lead author Dr Emily Cox of Express Scripts, Inc, St Louis, Missouri, and colleagues from other research centres in the US, and was published online on 31 October in the journal Pediatrics.

The researchers investigated commercial medical insurance claims made between 2002 and 2005 for a nationally representative sample of more than 3.5 million children aged from 5 to 19 years.

For each quarter of the three years covered by the study the researchers noted use of medication for the following chronic conditions: high blood pressure (antihypertensives), high blood fats (antihyperlipidemics), type 2 diabetes, antidepressants, asthma, attention deficit disorder and attention- deficit/hyperactivity disorder.

The results showed that:

  • The figures for medication use in the first quarter of the study period (first three monts of 2002, the baseline quarter) ranged from 29.5 per 1,000 child patients for asthma medication to 0.27 per 1,000 for antihyperlipidemics.
  • Except for asthma medication, the prevalence for older children, aged 15 to 19, was higher than for those who were younger than this.
  • The prevalence for type 2 diabetes medication doubled over the three years of the investigation.
  • This was driven mostly by a 166 per cent rise among females aged 10 to 14 and 135 per cent among females aged 15 to 19.
  • The highest rates of prevalence increase (in the double digits) were in medications for: asthma (46.5 per cent), attention-deficit disorder and attention-deficit/hyperactivity disorder medications (40.4 per cent), and antihyperlipidemics (15 per cent).
  • This compared with a more moderate growth in the use of antihypertensives and antidepressants (1.8 per cent).
  • The increase in prevalence rates for type 2 diabetes medication was far more dramatic for girls than for boys (147 versus 39 per cent).
  • There was a similar pattern for attention-deficit disorder and attention-deficit/hyperactivity disorder medications (63 versus 33 per cent), and antidepressants (7 versus 4 per cent).

In reporting their findings the authors commented that:

“Varying patterns were noted between males and females and across age groups. Particularly noteworthy are growing rates of use among female children, at times rates twice as great as among males.”

“These findings hold important implications for children’s health and health care costs in the United States,” they added.

And they concluded that:

“Prevalence of chronic medication use in children increased across all therapy classes evaluated. “

Cox and colleagues suggested more research was needed to look into the reasons behind this increase, including factors like growth in risk of chronic diseases among children, greater awareness of these conditions and more successful screening of them, and perhaps also a greater tendency to intervene earlier with drugs.

They also said more needs to be known about why the prevalence is growing faster for girls than for boys and also what this growing trend for both boys and girls means for overall child health..

Finally they wrote that:

“As chronic prescription use grows, so too do the risks of drug-related adverse effects and drug-drug interactions.”.

Although research is already going ahead to understand more about chronic diseases in childhood, “addressing the appropriateness of current treatment patterns must not be ignored,” they added.

“Trends in the Prevalence of Chronic Medication Use in Children: 2002-2005.”
Emily R. Cox, Donna R. Halloran, Sharon M. Homan, Sherry Welliver, and Douglas E. Mager.
Pediatrics, Vol. 122 No. 5 November 2008, pp. e1053-e1061, Published online 31 October.
doi:10.1542/peds.2008-0214.

Click here for Abstract.

Sources: Journal Article.

Written by: Catharine Paddock, PhD.