Evidence map›Paper›PMID 37016841›Full record

ArticleCanadian journal of psychiatry. Revue canadienne de psychiatrie2023

Impact of a Publicly-Funded Pharmacare Program on Prescription Stimulant use Among Children and Youth: A Population-Based Observational Natural Experiment.

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

Abstract read
In one paragraph

Article in Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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.

Tony AntoniouLi Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.ORCID 0000-0002-6984-8953
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.ORCID 0000-0003-1918-3540
Yona LunskyICES, Toronto, Ontario, Canada.ORCID 0000-0002-1866-9728
Melanie PennerAutism Research Centre, Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada.ORCID 0000-0002-8376-9768
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.ORCID 0000-0002-1468-1965

Funding

CIHR 166149
6 · The paper itself

Abstract

objectiveStimulants are first-line pharmacotherapy for individuals with attention-deficit hyperactivity disorder. However, disparities in drug coverage may contribute to inequitable treatment access. In January 2018, the government of Ontario, Canada, implemented a publicly-funded program (OHIP+) providing universal access to medications at no cost to children and youth between the ages of 0 and 24. In April 2019, the program was amended to cover only children and youth without private insurance. We studied whether these policy changes were associated with changes in prescription stimulant dispensing to Ontario children and youth.

methodsWe conducted a population-based observational natural experiment study of stimulant dispensing to children and youth in Ontario between January 2013 and March 2020. We used interventional autoregressive integrated moving average models to estimate the association between OHIP+ and its subsequent modification with stimulant dispensing trends.

resultsThe implementation of OHIP+ was associated with a significant immediate increase in the monthly rate of stimulant dispensing of 53.6 individuals per 100,000 population (95% confidence interval [CI], 36.8 to 70.5 per 100,000) and a 14.2% (95% CI, 12.8% to 15.6%) relative percent increase in stimulant dispensing rates between December 2017 and March 2019 (1198.6 vs. 1368.7 per 100,000 population). The April 2019 OHIP+ program amendment was associated with an increase in monthly stimulant dispensing trends of 10.2 individuals per 100,000 population (95% CI, 5.0 to 15.5), with rates increasing 7.5% (95% CI, 6.2% to 8.7%) between March 2019 and March 2020 (1368.7 vs. 1470.8 per 100,000 population). These associations were most pronounced among males, children and youth living in the highest income neighbourhoods and individuals aged 20 to 24.

conclusionA publicly-funded pharmacare program was associated with more children and youth being dispensed stimulants.

Indexed as

Attention Deficit Disorder with HyperactivityCentral Nervous System StimulantsAdolescentAdultChildChild, PreschoolHumansInfantInfant, NewbornMaleOntarioPrescriptionsYoung AdultCentral Nervous System Stimulantsadolescentcentral nervous system stimulantschildpolicyprescriptions/statistics & numerical data

Identifiers

PMID37016841
PMCPMC10590092

What OpenQuestion holds

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LicenceCC BY-NC
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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.