Trends in antidepressant prescriptions in children and young people in England, 1998-2017: protocol of a cohort study using linked primary care and secondary care datasets

Jack, Ruth H; Hollis, Chris; Coupland, Carol; Morriss, Richard; Knaggs, Roger David; Cipriani, Andrea; Cortese, Samuele; Hippisley-Cox, Julia

Abstract

Introduction
Increasing numbers of children and young people (CYP) are receiving prescriptions for antidepressants. This is the protocol of a study aiming to describe the trends and variation in antidepressant prescriptions in CYP in England, and to examine the indications for the prescriptions recorded and whether there was contact with secondary care specialists on or around the time of the first antidepressant prescription.
Methods and analysis
All eligible CYP aged between 5-17 years in 1998-2017 from the QResearch primary care database will be included. Incidence and prevalence rates of any antidepressant prescription in each year will be calculated. We will examine four different antidepressant classes: selective serotonin reuptake inhibitors (SSRIs), tricyclic and related antidepressants (TCAs), serotonin and norepinephrine reuptake inhibitors (SNRIs) and other antidepressants, as well as for individual drugs. Linked primary and secondary care data (hospital episode statistics) in the year before and up to six months after the first antidepressant prescription will be examined for CYP whose first antidepressant prescription was in 2006-2017. Whether there were records of indications and being seen by psychiatric or paediatric specialists will be identified. Trends over time and differences by region, deprivation and ethnicity will be examined using Poisson regression.
Discussion
This large, population-based study will give an up-to-date picture of antidepressant prescribing in CYP and identify any variation. Understanding what indications are recorded when CYP are being prescribed antidepressants, and whether this was done in partnership with secondary care specialists, will provide evidence of whether appropriate guidelines are being followed.

Citation

Jack, R. H., Hollis, C., Coupland, C., Morriss, R., Knaggs, R. D., Cipriani, A., …Hippisley-Cox, J. (2019). Trends in antidepressant prescriptions in children and young people in England, 1998-2017: protocol of a cohort study using linked primary care and secondary care datasets. Evidence-Based Mental Health, 22(3), 129-133. https://doi.org/10.1136/ebmental-2019-300097

• Journal Article Type: Article
• Acceptance Date: Jun 14, 2019
• Online Publication Date: Jun 28, 2019
• Publication Date: 2019-08
• Deposit Date: Jun 20, 2019
• Publicly Available Date: Jun 20, 2019
• Journal: Evidence Based Mental Health
• Electronic ISSN: 1468-960X
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 22
• Issue: 3
• Pages: 129-133
• DOI: https://doi.org/10.1136/ebmental-2019-300097
• Keywords: Psychiatry and Mental health
• Public URL: https://nottingham-repository.worktribe.com/output/2211885
• Publisher URL: https://ebmh.bmj.com/content/early/2019/06/28/ebmental-2019-300097