Descriptive analysis of poisoning cases involving attention deficit hyperactivity disorder medications in Hong Kong

Abstract

Introduction: The number of poisoning cases involving attention deficit hyperactivity disorder (ADHD) medications has reportedly risen with their increased use. However, there is limited relevant evidence from Asia. We analysed the characteristics of poisoning events involving these medications in Hong Kong. Methods: We retrieved data regarding ADHD medication–related poisoning cases from the Hong Kong Poison Information Centre and conducted a descriptive analysis of the demographic information and poisoning information including sources of cases, exposure reason, exposure location, and outcome. The HKPIC data were linked with the Hospital Authority Clinical Data Analysis and Reporting System (CDARS) via de-identified Accident and Emergency numbers of public hospitals to investigate clinical characteristics. We also retrieved ADHD medication prescription records from the CDARS, then compared trends between poisoning cases and ADHD medication use. Results: We identified 72 poisoning cases involving ADHD medications between 2009 and 2019, of which approximately 70% occurred in the affected individual’s residence; most were intentional poisoning events (65.3%). No statistically significant association was observed between ADHD medication prescription trends and poisoning events involving ADHD medications. Of the 66 cases (91.7%) successfully linked to CDARS, 40 (60.6%) occurred in individuals with ADHD (median age: 14 years); 26 (39.4%) occurred in individuals who lacked ADHD (median age: 33 years) but displayed higher rates of other mental disorders including depression and anxiety. Conclusion: No significant correlation was evident between ADHD medication prescriptions and poisoning events involving ADHD medications. However, medication management and caregiver education must be emphasised to prevent potential poisoning events.

簡介：隨着治療專注力不足過度活躍症（ADHD）藥物的使用量上升，涉及這些藥物的中毒事例也有所增加。然而在亞洲地區，相關的研究證據有限。本項研究分析了香港ADHD藥物中毒事例的臨床特徵。方法：本研究從香港中毒諮詢中心檢索了涉及ADHD藥物相關中毒事件的記錄，並描述了中毒案例的人口特徵以及分析中毒相關的資料，包括個案源、中毒原因、中毒事件發生地點和中毒結果。本研究利用去除識別的公立醫院急症室編碼，將這些中毒記錄與醫院管理局 臨床數據分析和報告系統的醫療電子病歷連接，以分析臨床特徵。最後，我們在臨床數據分析和報告系統中檢索ADHD藥物的處方記錄，並比較發生ADHD藥物中毒事例及ADHD藥物使用之間的趨勢。結果：我們發現在2009至2019年共有72宗涉及ADHD藥物的中毒事例，其中約70%發生在病人家中，並且大多數（65.3%）為非意外中毒事例。分析顯示，ADHD藥物處方和涉及ADHD藥物的中毒事例的趨勢並無關聯。在成功連接到電子病歷的66宗中毒事件（91.7%）之中，有40宗（60.6%）的病人患有ADHD（中位年齡：14歲）；26宗（39.4%）發生在沒有ADHD（中位年齡：33歲）但患抑鬱和焦慮等其他精神疾病的比例較高的患者。結論：研究顯示，ADHD藥物處方和涉及ADHD藥物的中毒事件的趨勢並沒有顯著關聯。然而，藥物管理和對相關患者及家屬的教育在預防潛在中毒方面仍至關重要。