Published on: 8th September 2016
Case Study 10
By using health record data that had been made anonymous, a research team at Swansea University, led by The Farr Institute’s Dr Ann John, explored the increased use of drug therapies for mental health issues in children and young people.
There is growing public concern that increasing numbers of young people are having problems with anxiety and depression and that these problems are being treated with medication. Some take this further believing that prescribing patterns “over-medicalise” problems like teenage anxiety that could be also considered as a normal part of growing up into adults. Medication choices for teenagers are complicated because many drugs used to treat depression and anxiety are often not fully tested or licensed for use in these age groups. Health guidelines point out that first options in treatment should be “talking therapies” for milder cases. However, many countries are reporting increased use of drug therapies for mental health issues in children and young people.
To conduct their research, the team used information from the SAIL Databank, a world-class system that brings data together in a secure, trusted and confidential way. They used health record data was made anonymous so that individuals couldn’t be identified. This allowed the team to study a population of over 300,000 children and young people aged 6 to 18 between the years 2003 and 2011. They looked for evidence of children and young people with anxiety or symptoms of anxiety and the patterns of medicine they were prescribed. In particular, the team focussed on drugs that induce sleep (hypnotics) or relieve anxiety (anxiolytics).
The team found that between 2003 and 2011 the rate of young people showing anxiety symptoms for the first time more than tripled. Prescriptions of sleep inducing or anxiety releieving medicines did not change much over time but the results showed a significant increase in 15 to 18-year-olds. Another striking finding for this group was that these medicines are prescribed over 50 per cent more often for girls than boys.
The study showed that more 15 to 18-year-olds are being prescribed sleep inducing or anxiety releieving medication than should be within the current health guidelines. The research emphasised the value of more specific guidance for doctors when prescribing medication for this age group.
The team is now working with Welsh Government, the Welsh Medicines Resource Centre and Health Boards to improve practice in Wales. The Welsh Medicines Resource Centre, is a source of independent information on issuing prescriptions for healthcare professionals like GPs. They issued a bulletin and case study based on the team’s work around prescriptions for children and young people with depression. The results of this research have provided evidence that will support health systems to better manage the medicines prescribed to children and teenagers with anxiety. The findings will also inform how child and adolescent mental health services can be re-designed in Wales and further afield.
For more information about anxiety visit www.nhsdirect.wales.nhs.uk/Encyclopaedia/a/article/anxiety
Enquiries to Sarah Toomey, Communications Officer, Farr Institute CIPHER