Evidence map›Paper›PMID 36631810›Full record

ArticleBMC public health2023

Geographic variation and sociodemographic correlates of prescription psychotropic drug use among children and youth in Ontario, Canada: a population-based study.

Tony Antoniou, Daniel McCormack, Sophie Kitchen, Kathleen Pajer, William Gardner, Yona Lunsky, Melanie Penner, Mina Tadrous, Muhammad Mamdani, David N Juurlink and 1 more

Open access · goldAbstract read
In one paragraph

Article in BMC public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.6field-weighted citation impact, top 19% 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

6 citing papers in PubMed, 7 citations in OpenAlex.

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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

11 authors at 6 institutions in 1 country.

Tony AntoniouLi Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada. Tony.antoniou@unityhealth.to.
Daniel McCormackICES, Toronto, Ontario, Canada.
Sophie KitchenICES, Toronto, Ontario, Canada.
Kathleen PajerChildren's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada.
William GardnerICES, Toronto, Ontario, Canada.
Yona LunskyICES, Toronto, Ontario, Canada.
Melanie PennerAutism Research Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.
Mina TadrousICES, Toronto, Ontario, Canada.
Muhammad MamdaniLi Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.
David N JuurlinkICES, Toronto, Ontario, Canada.
Tara GomesLi Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.
Institute for Clinical Evaluative Sciences · CASt. Michael's Hospital · CAUniversity of Toronto · CACentre for Addiction and Mental Health · CAChildren's Hospital of Eastern Ontario · CAHolland Bloorview Kids Rehabilitation Hospital · CA

Funding

CIHR 166149
6 · The paper itself

Abstract

backgroundPopulation-based research examining geographic variability in psychotropic medication dispensing to children and youth and the sociodemographic correlates of such variation is lacking. Variation in psychotropic use could reflect disparities in access to non-pharmacologic interventions and identify potentially concerning use patterns.

methodsWe conducted a population-based study of all Ontario residents aged 0 to 24 years who were dispensed a benzodiazepine, stimulant, antipsychotic or antidepressant between January 1, 2018, and December 31, 2018. We conducted small-area variation analyses and identified determinants of dispensing using negative binomial generalized estimating equation models.

resultsThe age- and sex-standardized rate of psychotropic dispensing to children and youth was 76.8 (range 41.7 to 144.4) prescriptions per 1000 population, with large variation in psychotropic dispensing across Ontario's census divisions. Males had higher antipsychotic [rate ratio (RR) 1.40; 95% confidence interval (CI) 1.36 to 1.44) and stimulant (RR 1.75; 95% CI 1.70 to 1.80) dispensing rates relative to females, with less use of benzodiazepines (RR 0.85; 95% CI 0.83 to 0.88) and antidepressants (RR 0.81; 95% CI 0.80 to 0.82). Lower antipsychotic dispensing was observed in the highest income neighbourhoods (RR 0.72; 95% CI 0.70 to 0.75) relative to the lowest. Benzodiazepine (RR 1.12; 95% CI 1.01 to 1.24) and stimulant (RR 1.11; 95% CI 1.01 to 1.23) dispensing increased with the density of mental health services in census divisions, whereas antipsychotic use decreased (RR 0.82; 95% CI 0.73 to 0.91). The regional density of child and adolescent psychiatrists and developmental pediatricians (RR 1.00; 95% CI 0.99 to 1.01) was not associated with psychotropic dispensing.

conclusionWe found significant variation in psychotropic dispensing among young Ontarians. Targeted investment in regions with long wait times for publicly-funded non-pharmacological interventions and novel collaborative service models may minimize variability and promote best practices in using psychotropics among children and youth.

Indexed as

Antipsychotic AgentsAdolescentAntidepressive AgentsBenzodiazepinesChildDrug PrescriptionsFemaleHumansMaleOntarioPsychotropic DrugsResearch DesignAntidepressive AgentsAntipsychotic AgentsBenzodiazepinesPsychotropic DrugsAdolescentChildGeographic variationPrescriptions / statistics & numerical dataPsychotropic drugsSmall-area analysisSocioeconomic factors

Identifiers

PMID36631810
PMCPMC9832754
OpenAlexW4315574559

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.