Evidence map›Paper›PMID 29290742›Full record

ArticleThe journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG

Off-label Prescribing Trends for ADHD Medications in Very Young Children.

Shannon G Panther, Alice M Knotts, Tamara Odom-Maryon, Kenneth Daratha, Teri Woo, Tracy A Klein

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.

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  13. Trazodone Prescribing for Children With Attention Deficit Hyperactivity Disorder on Medicaid in Oregon.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2022
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 1 country.

Shannon G PantherCollege of Pharmacy (SGP, AMK), Washington State University, Spokane, Washington, College of Nursing (KD, TAK, TO), Washington State University, Vancouver and Spokane, Washington, and School of Nursing (TW), Pacific Lutheran University, Tacoma, Washington.
Alice M KnottsCollege of Pharmacy (SGP, AMK), Washington State University, Spokane, Washington, College of Nursing (KD, TAK, TO), Washington State University, Vancouver and Spokane, Washington, and School of Nursing (TW), Pacific Lutheran University, Tacoma, Washington.
Tamara Odom-MaryonCollege of Pharmacy (SGP, AMK), Washington State University, Spokane, Washington, College of Nursing (KD, TAK, TO), Washington State University, Vancouver and Spokane, Washington, and School of Nursing (TW), Pacific Lutheran University, Tacoma, Washington.
Kenneth DarathaCollege of Pharmacy (SGP, AMK), Washington State University, Spokane, Washington, College of Nursing (KD, TAK, TO), Washington State University, Vancouver and Spokane, Washington, and School of Nursing (TW), Pacific Lutheran University, Tacoma, Washington.
Teri WooCollege of Pharmacy (SGP, AMK), Washington State University, Spokane, Washington, College of Nursing (KD, TAK, TO), Washington State University, Vancouver and Spokane, Washington, and School of Nursing (TW), Pacific Lutheran University, Tacoma, Washington.
Tracy A KleinCollege of Pharmacy (SGP, AMK), Washington State University, Spokane, Washington, College of Nursing (KD, TAK, TO), Washington State University, Vancouver and Spokane, Washington, and School of Nursing (TW), Pacific Lutheran University, Tacoma, Washington.
Pacific Lutheran University · USWashington State University Spokane · USWashington College · USWashington State University Vancouver · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis study examines off-label medication prescribing use and trends in children on Medicaid with ADHD with particular focus on the very young (under age 6 years).

methodsThis was an observational cohort study and retrospective analysis of ADHD medication prescriptions from Oregon Medicaid records (N = 83,190) in 2012. Manufacturer prescribing information was used to determine off-label designation. Children ages 3 to 18 years at the time of prescription who had continuous Medicaid enrollment of at least 10 months during the index year of 2012 were included in the sample frame.

resultsChildren with ADHD were prescribed off-label medications primarily at the ages of 5 years and younger. Among children ages 3 to 5 years, 91.4% of prescriptions were off-label. After the age of 5 years, the percentage of off-label prescriptions dropped notably to 21%, reflecting the increase in availability of approved medications for the treatment of ADHD starting at age 6 years. In the 3- to 5-year-old age group, specific off-label and concerning medication-related observations included a high frequency of alpha agonist (e.g., guanfacine, clonidine) prescribing; the prescribing of untested formulations such as clonidine patches; prescribing of atomoxetine; and prescribing of large doses of stimulant medications.

conclusionsMost ADHD drugs prescribed for very young children are off-label, which is concerning owing to lack of safety and efficacy data in this vulnerable population.

Indexed as

attention deficit disorderdrug prescribingoff-label usepreschool child

Identifiers

PMID29290742
PMCPMC5736254
OpenAlexW2778573170

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.