Drug utilization pattern in children with Autism Spectrum Disorder (ASD) in Asian countries: a population based study

Abstract

BACKGROUND: A recent study has reported an increase rate of ASD in Chinese population. No current evidence on medication use for ASD treatment in Chinese children has been reported. There is need to investigate medication use in this population. OBJECTIVES: The aim of this study was to investigate the current pharmacological treatments patterns among a cohort of children diagnosed with ASD in Taiwan (TW) and Hong Kong (HK). METHODS: Patients who aged younger than 12 years old with autism diagnosis (ICD-9-CM 299.xx) were identified from the National Health Insurance Research Database (NHIRD) and registry for catastrophic illness between 2000 to 2010 in TW and the Clinical Data and Reporting System (CDARS) database between 2001 and 2010 in HK. Based on literature review, agents found to be possibly efficacious of those patients were studied. Psychotropic drug use was assessed within one year after the first diagnosis of ASD was recorded. Results: A total of 11,825 (5,501 from TW; 6,324 from HK) of ASD children were identified. The majority of patients were boys (84.0% for TW; 87.2% for HK), and median age at diagnosis were 5 years old in both areas. 2,354 patients (1,740 (31.6%) from TW, 614 (9.7%) from HK) received at least one prescription of psychotropic drug within the study period. There is variation of prescribing pattern in TW and HK. In TW, the most commonly prescribed medications were stimulants (1,018 patients, 58.5%), antipsychotics (615 patients, 35.3%), anxiolytics (477 patients, 27.4%), antidepressant (227 patients, 13.0%), and clonidine (128 patients, 7.4%). In HK, stimulants was also the most commonly prescribed medication (506 patients, 82.4%), followed by antipsychotics (133 patients, 21.7%), anxiolytics (78 patients, 12.7%), and antidepressant (31 patients, 5.0%). Of these stimulants, methylphenidate was the most commonly prescribed drug in both TW and HK (70.1% in TW, 92.1% in HK). CONCLUSIONS: This study showed one-third of ASD children received medication treatment in TW whereas it was only one-tenth of children received treatment in HK. Further research is needed to evaluate the effectiveness and safety of this utilization.