Prescribing of methylphenidate to children and adolescents in South Africa: A pharmacoepidemiological investigation

Abstract

Background: Pharmacoepidemiological studies on ADHD are limited in South Africa. The primary aim was to analyse the prescribing of methylphenidate to patients aged 18 years and younger in the private health care sector. Methods: Data for a one-month period in 2004 were obtained from a large medical aid administrator. Data were retrospectively analysed. The total database contained medicine records for 355 998 patients. Results: A total of 66 450 medicine items were prescribed to 34 733 patients aged 18 years and younger. A total of 1 028 patients received prescriptions for methylphenidate. Nearly 3% of children and adolescents therefore received prescriptions for methylphenidate. The average age of these patients was 10.87 (SD = 2.79) years. Most of these prescriptions (63.14%) were for children between seven and twelve years of age. Most prescriptions were for long-acting methylphenidate in 20 mg, 30 mg and 40 mg capsules (48.87%). The average prescribed daily dose (PDD) for methylphenidate was 19.27 (SD = 11.87) mg. The most popular average PDD was 20 mg (42.63% of all methylphenidate prescriptions). The highest average percentage of methylphenidate prescriptions was in the Western Cape (2.58%), and the lowest in the Northern Cape (0.63%). Conclusions: Numerous claims are being made that methylphenidate is overused or even abused, especially in children of school-going age. Most
prescriptions were issued in metropolitan areas in this study, but overuse could not be established. This study was a preliminary study that can lead to more comprehensive studies in future.