National prescribing rates and polypharmacy for children and young people in New Zealand with and without autism spectrum disorder

Abstract

Background: International data and guidance on prescribing for children and young people with autism spectrum disorder (ASD) are limited. National administrative datasets such as the New Zealand Integrated Data Infrastructure (IDI) may offer a cost-effective and sustainable way to monitor prescribing trends in the context of clinical and systemic change. Method: Medication dispensing for New Zealand children and young people with ASD was explored using the IDI. Psychotropic and non-psychotropic medication dispensing rates, and rates of polypharmacy within a one-year period were examined. Comparisons of medication use were made to children and young people with another neurodevelopmental condition, attention deficit hyperactivity disorder (ADHD), and the general population. Results: The vast majority (83 %) of children and young people with ASD were prescribed medication within a one-year period and they received a mean of four unique medications. High dispensing of antihistamine, asthma, gastrointestinal, and psychotropic medications was observed. Just over half (57 %) of those with ASD experienced polypharmacy of three or more medications, and 11 % of 10 or more. Medication dispensing rates were significantly higher among the ASD group compared to those with ADHD and the general population. Polypharmacy rates were higher among both the ASD and ADHD group compared to the general population. Conclusions: It is clear that New Zealand children and young people with ASD experience a significant and disproportionate medication burden. Although further investigation is needed to fully understand underlying reasons and clinical implications, the IDI appears to be a valuable means of monitoring prescribing trends over time.