Rise in psychotropic meds for children during COVID
Prescribing of psychotropic medication (antidepressant / antianxiety) for children and adolescents by GPs increased during the COVID-19 pandemic
28 April 2023
Psychotropic medication prescribing by GPs for children aged 5-19 years increased during the period March 2020 to November 2021 relative to pre-pandemic forecasted rates, indicating a reliance on GPs to provide mental health care to children and adolescents when other medical and social support services were less available.
This new research by Macquarie University shows that while rates of psychotropic medication prescribing by GPs for children has been increasing since 2018, the peak rates reached during the pandemic were higher than forecast.
The research, led by Dr Rae-Anne Hardie from the Australian Institute of Health Innovation at Macquarie University, examined the longitudinal trends of prescribing rates of psychotropic medications (antidepressants, antipsychotics, anxiolytics, psychostimulants, and hypnotics and sedatives) by GPs for patients aged 5-19 years.
Deidentified general practice data was provided from five Primary Health Networks (PHNs) in New South Wales and Victoria as owners of the data, including Central and Eastern Sydney PHN, South Western Sydney PHN, South Eastern Melbourne PHN, Eastern Melbourne PHN, and Gippsland PHN, accounting for inner urban, suburban and rural / regional practice settings and a diverse range of GP demographics. The research utilised more than 1.4 million electronic health records for the period January 2018 to November 2021 (pre-pandemic: January 2018-February 2020; pandemic period: March 2020-November 2021).
Researchers and GPs involved in the project surmise the increases in psychotropic medication prescribing may have been due to greater reliance on GPs by patients and families during the pandemic who were faced with longer wait times for mental health services and school attendance disruption.
“GPs played an incredibly important role supporting children and families during the pandemic and these figures highlight the increased mental health concerns of some groups, and restricted access to other support services,” Dr Hardie said.
Associate Professor Christopher Pearce, Research Director, Aurora Primary Care Research Institute, was a co-author on the paper. “The COVID pandemic hit general practice very hard – at the time we were being swamped with COVID cases and we had to deal with the effects of isolation. This hit adolescents very hard – they are social creatures. At the same time many support resources were unavailable or were themselves swamped,” Associate Professor Pearce said.
“Supporting general practice were the primary health networks – that were also facing rapid changes. Being able to access data like this from the research was important then, and continues to be so,” he said.
The research furthered a collaborative partnership facilitated by the Digital Health Cooperative Research Centre (DHCRC) aimed at developing an evidence base to address the longer-term impacts of COVID-19.
“This data is a stark reminder of both the personal and societal impact of the global pandemic on all Australians, and especially in some of our most vulnerable communities,” said DHCRC CEO Annette Schmiede. “Building evidenced-based research is critical to ensure that those most impacted by COVID-19 receive the best support possible moving forward."
Higher rates of prescribing of antidepressants, relative to forecast rates, were observed in all age groups from March 2020, but most prominently in ages 5-9 where prescriptions increased up to a peak of 4.5 times higher than forecast.
A peak prescribing rate increase of 1.5 times the forecasted rate for psychostimulants occurred in ages 5-9 later in 2020.
Anxiolytic prescribing rates increased for all ages, most clearly for 5-9, followed by 15-19. At its peak, the increase relative to forecast rates was 3.5 times higher in both these groups.
Antipsychotics increased for all age groups, most prominently for 5-9 where prescriptions rose six times higher than forecasted rates at the peak.
The portion of prescriptions with five repeats also increased markedly during March 2020, however, the portion of no repeat prescriptions constituted 64% of all prescriptions.
Dr Precious McGuire, GP and Clinical Editor for Health Pathways Melbourne, co-authored the paper and said: “As a practicing general practitioner, it was great to be involved in this research from the outset. Clinician input improved the recognition of factors affecting the collected data and ensured clinical relevance.”
Caption: Dr Rae-Anne Hardie and Associate Professor Chris Pearce
The research is published in the Medical Journal of Australia.
Access the media coverage with these links:
MJA InSight+ article here.
The Lighthouse article here.
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Centre for Health Systems and Safety Research
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