Regulatory action and moderate decrease in methylphenidate use among ADHD diagnosed patients aged five and under in Korea

Ju Young Shin, Shin Haeng Lee, Sun Mi Shin, Han Na Shin, Byung Joo Park

Research output: Contribution to journalArticleResearchpeer-review

1 Citation (Scopus)

Abstract

In December 2009, Korean regulatory agency announced that methylphenidate, a drug used to treat attention deficit-hyperactivity disorder (ADHD), should not be used in children aged five and under due to the risk of sudden cardiac death. This study examined the impact of regulatory action and prescribing patterns. We conducted a time series analysis using the Korea National Health Insurance Service database. Study subjects included children under 18. years old with ADHD from January 2007 to December 2011. Contraindicated use of methylphenidate was defined as use of methylphenidate at least once in children aged five and under. We selected additional control points (2007, 2008, and 2010) and compared the methylphenidate use one year before and after each point. We calculated relative and absolute reductions, and 95% confidence intervals. The total number of ADHD patients was 376,298. Overall, there was a 70.87% relative reduction (95% CI: 63.33%-79.31%) and a 0.93% absolute reduction (95% CI: 0.51%-0.60%) of methylphenidate use. The relative and absolute reductions were 27.61% (95% CI: 24.76%-30.78%) and 0.31% (95% CI: 0.21%-0.41%) in 2007; 43.58% (95% CI: 38.02%-49.96%) and 0.35% (95% CI: 0.27%-0.43%) in 2008; 46.52% (95% CI: 38.86%-55.70%) and 0.21 (95% CI: 0.15%-0.27%) in 2009; and 10.20% (95% CI: 8.32%-12.50%) and 0.02% (95% CI: 0.02%-0.07%) in 2010. Korean regulatory action led to a moderate decrease in contraindicated methylphenidate use even after the steep decline before the regulatory action.

Original languageEnglish
Pages (from-to)244-248
Number of pages5
JournalRegulatory Toxicology and Pharmacology
Volume72
Issue number2
DOIs
StatePublished - 1 Jul 2015

Fingerprint

Methylphenidate
Attention Deficit Disorder with Hyperactivity
Korea
National Health Programs
Health insurance
Time series analysis
Sudden Cardiac Death
Databases
Confidence Intervals
Pharmaceutical Preparations

Keywords

  • ADHD
  • Children
  • Methylphenidate
  • Population-based study

Cite this

@article{b67e70a02e074c5a8751b6368e2d7b61,
title = "Regulatory action and moderate decrease in methylphenidate use among ADHD diagnosed patients aged five and under in Korea",
abstract = "In December 2009, Korean regulatory agency announced that methylphenidate, a drug used to treat attention deficit-hyperactivity disorder (ADHD), should not be used in children aged five and under due to the risk of sudden cardiac death. This study examined the impact of regulatory action and prescribing patterns. We conducted a time series analysis using the Korea National Health Insurance Service database. Study subjects included children under 18. years old with ADHD from January 2007 to December 2011. Contraindicated use of methylphenidate was defined as use of methylphenidate at least once in children aged five and under. We selected additional control points (2007, 2008, and 2010) and compared the methylphenidate use one year before and after each point. We calculated relative and absolute reductions, and 95{\%} confidence intervals. The total number of ADHD patients was 376,298. Overall, there was a 70.87{\%} relative reduction (95{\%} CI: 63.33{\%}-79.31{\%}) and a 0.93{\%} absolute reduction (95{\%} CI: 0.51{\%}-0.60{\%}) of methylphenidate use. The relative and absolute reductions were 27.61{\%} (95{\%} CI: 24.76{\%}-30.78{\%}) and 0.31{\%} (95{\%} CI: 0.21{\%}-0.41{\%}) in 2007; 43.58{\%} (95{\%} CI: 38.02{\%}-49.96{\%}) and 0.35{\%} (95{\%} CI: 0.27{\%}-0.43{\%}) in 2008; 46.52{\%} (95{\%} CI: 38.86{\%}-55.70{\%}) and 0.21 (95{\%} CI: 0.15{\%}-0.27{\%}) in 2009; and 10.20{\%} (95{\%} CI: 8.32{\%}-12.50{\%}) and 0.02{\%} (95{\%} CI: 0.02{\%}-0.07{\%}) in 2010. Korean regulatory action led to a moderate decrease in contraindicated methylphenidate use even after the steep decline before the regulatory action.",
keywords = "ADHD, Children, Methylphenidate, Population-based study",
author = "Shin, {Ju Young} and Lee, {Shin Haeng} and Shin, {Sun Mi} and Shin, {Han Na} and Park, {Byung Joo}",
year = "2015",
month = "7",
day = "1",
doi = "10.1016/j.yrtph.2015.04.022",
language = "English",
volume = "72",
pages = "244--248",
journal = "Regulatory Toxicology and Pharmacology",
issn = "0273-2300",
publisher = "Academic Press Inc.",
number = "2",

}

Regulatory action and moderate decrease in methylphenidate use among ADHD diagnosed patients aged five and under in Korea. / Shin, Ju Young; Lee, Shin Haeng; Shin, Sun Mi; Shin, Han Na; Park, Byung Joo.

In: Regulatory Toxicology and Pharmacology, Vol. 72, No. 2, 01.07.2015, p. 244-248.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Regulatory action and moderate decrease in methylphenidate use among ADHD diagnosed patients aged five and under in Korea

AU - Shin, Ju Young

AU - Lee, Shin Haeng

AU - Shin, Sun Mi

AU - Shin, Han Na

AU - Park, Byung Joo

PY - 2015/7/1

Y1 - 2015/7/1

N2 - In December 2009, Korean regulatory agency announced that methylphenidate, a drug used to treat attention deficit-hyperactivity disorder (ADHD), should not be used in children aged five and under due to the risk of sudden cardiac death. This study examined the impact of regulatory action and prescribing patterns. We conducted a time series analysis using the Korea National Health Insurance Service database. Study subjects included children under 18. years old with ADHD from January 2007 to December 2011. Contraindicated use of methylphenidate was defined as use of methylphenidate at least once in children aged five and under. We selected additional control points (2007, 2008, and 2010) and compared the methylphenidate use one year before and after each point. We calculated relative and absolute reductions, and 95% confidence intervals. The total number of ADHD patients was 376,298. Overall, there was a 70.87% relative reduction (95% CI: 63.33%-79.31%) and a 0.93% absolute reduction (95% CI: 0.51%-0.60%) of methylphenidate use. The relative and absolute reductions were 27.61% (95% CI: 24.76%-30.78%) and 0.31% (95% CI: 0.21%-0.41%) in 2007; 43.58% (95% CI: 38.02%-49.96%) and 0.35% (95% CI: 0.27%-0.43%) in 2008; 46.52% (95% CI: 38.86%-55.70%) and 0.21 (95% CI: 0.15%-0.27%) in 2009; and 10.20% (95% CI: 8.32%-12.50%) and 0.02% (95% CI: 0.02%-0.07%) in 2010. Korean regulatory action led to a moderate decrease in contraindicated methylphenidate use even after the steep decline before the regulatory action.

AB - In December 2009, Korean regulatory agency announced that methylphenidate, a drug used to treat attention deficit-hyperactivity disorder (ADHD), should not be used in children aged five and under due to the risk of sudden cardiac death. This study examined the impact of regulatory action and prescribing patterns. We conducted a time series analysis using the Korea National Health Insurance Service database. Study subjects included children under 18. years old with ADHD from January 2007 to December 2011. Contraindicated use of methylphenidate was defined as use of methylphenidate at least once in children aged five and under. We selected additional control points (2007, 2008, and 2010) and compared the methylphenidate use one year before and after each point. We calculated relative and absolute reductions, and 95% confidence intervals. The total number of ADHD patients was 376,298. Overall, there was a 70.87% relative reduction (95% CI: 63.33%-79.31%) and a 0.93% absolute reduction (95% CI: 0.51%-0.60%) of methylphenidate use. The relative and absolute reductions were 27.61% (95% CI: 24.76%-30.78%) and 0.31% (95% CI: 0.21%-0.41%) in 2007; 43.58% (95% CI: 38.02%-49.96%) and 0.35% (95% CI: 0.27%-0.43%) in 2008; 46.52% (95% CI: 38.86%-55.70%) and 0.21 (95% CI: 0.15%-0.27%) in 2009; and 10.20% (95% CI: 8.32%-12.50%) and 0.02% (95% CI: 0.02%-0.07%) in 2010. Korean regulatory action led to a moderate decrease in contraindicated methylphenidate use even after the steep decline before the regulatory action.

KW - ADHD

KW - Children

KW - Methylphenidate

KW - Population-based study

UR - http://www.scopus.com/inward/record.url?scp=84928981216&partnerID=8YFLogxK

U2 - 10.1016/j.yrtph.2015.04.022

DO - 10.1016/j.yrtph.2015.04.022

M3 - Article

VL - 72

SP - 244

EP - 248

JO - Regulatory Toxicology and Pharmacology

JF - Regulatory Toxicology and Pharmacology

SN - 0273-2300

IS - 2

ER -