Published on: 8th September 2016
Case Study 10
Project lead: Dr Ann John, Swansea University
By using health record data that had been made anonymous, a research team at Swansea University 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.
The research team at Swansea University used anonymised health record data from the SAIL Databank forming a study 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 presenting with anxiety or symptoms of anxiety and the patterns of prescribing that followed. Most focus was on classes of drugs that induce sleep (hypnotics) or relieve anxiety (anxiolytics).
The team found that over the course of the study years the rate of young people newly presenting with anxiety symptoms more than tripled. General prescribing of hypnotics or anxiolytics (for all children and young adults) did not change much over time; however there was a significant increase in the 15 to 18-year-old group. Another striking finding for this group was that prescribing of hypnotics or anxiolytics was over 50 per cent greater for girls than boys.
The finding of increased use of hypnotics and anxiolytics in the 15 to 18-year-old group is out of keeping with current prescribing guidelines. The team emphasise the value of targeted specific guidance on prescription and management for this group presenting at their GP (particularly older teenagers) with anxiety.
The team is now working with Welsh Government, the Welsh Medicines Resource Centre and Health Boards to improve practice. For example, The Welsh Medicines Resource Centre has recently issued a bulletin and case study based on their work of prescribing in children and young people with depression (March 2016). This feedback to improve prescribing practice on the basis of research evidence demonstrates the value of health informatics research. The team’s findings also informed on-going programmes to redesign child and adolescent mental health services in Wales and further afield.
For more information about anxiety visit www.nhsdirect.wales.nhs.uk/Encyclopaedia/a/article/anxiety
For further information visit:
Enquiries to Sarah Toomey, Communications Officer, Farr Institute CIPHER