Tuesday, April 2nd, 2013
Over the past decade, diagnoses of attention deficit hyperactivity disorder (ADHD) have grown exponentially, with 11 percent of school age children–and 1 in 5 boys–having a diagnosis. The New York Times reports on the new numbers, which come from research by the Centers for Disease Control and Prevention:
The figures showed that an estimated 6.4 million children ages 4 through 17 had received an A.D.H.D. diagnosis at some point in their lives, a 16 percent increase since 2007 and a 53 percent rise in the past decade. About two-thirds of those with a current diagnosis receive prescriptions for stimulants like Ritalin or Adderall, which can drastically improve the lives of those with A.D.H.D. but can also lead to addiction, anxiety and occasionally psychosis.
“Those are astronomical numbers. I’m floored,” said Dr. William Graf, a pediatric neurologist in New Haven and a professor at the Yale School of Medicine. He added, “Mild symptoms are being diagnosed so readily, which goes well beyond the disorder and beyond the zone of ambiguity to pure enhancement of children who are otherwise healthy.”
And even more teenagers are likely to be prescribed medication in the near future because the American Psychiatric Association plans to change the definition of A.D.H.D. to allow more people to receive the diagnosis and treatment. A.D.H.D. is described by most experts as resulting from abnormal chemical levels in the brain that impair a person’s impulse control and attention skills.
While some doctors and patient advocates have welcomed rising diagnosis rates as evidence that the disorder is being better recognized and accepted, others said the new rates suggest that millions of children may be taking medication merely to calm behavior or to do better in school. Pills that are shared with or sold to classmates — diversion long tolerated in college settings and gaining traction in high-achieving high schools — are particularly dangerous, doctors say, because of their health risks when abused.
Image: ADHD, via Shutterstock
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Thursday, March 21st, 2013
Black children are less likely than kids of other races to receive prescriptions for antibiotics when they visit the doctor, according to a study published this week in the journal Pediatrics. More from the blog The Grio:
The findings are based on 1.3 million doctor visits with the same 222 providers, and were independent of age, gender or type of insurance.
This is not the first time research has shown racial biases among health professionals. A smaller study at the University of Washington, showed that unconscious racial biases affected the amount of pain medication given to black children when they needed it. And a Johns Hopkins study highlighted that primary physicians with unconscious racial biases tended to dominate conversations with black patients, ignore their social needs and exclude them from the decision-making process.
However, today’s study is one of the few to look at its effects on respiratory infections and antibiotic use in children.
“Our goal has always been to find ways to improve antibiotic prescribing for children,” says study author Dr. Jeffrey S. Gerber, who is also assistant professor of pediatrics at the University of Pennsylvania School of Medicine’s Division of Infectious Diseases.
“These analyses [then] revealed the differences in prescribing by race.”
Although, what this study has uncovered may not be a negative. In the age of antibiotic overprescribing and the fear that unnecessary antibiotics later lead to “superbugs” that are too strong to treat, this may in fact be a good thing.
“Overprescribing of antibiotics to children with [respiratory tract infections] is common,” Gerber says.
Image: Child at the doctor, via Shutterstock
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Wednesday, November 21st, 2012
Children who are the youngest in their school classes are more likely to score lower on standardized tests, and to receive medications for attention deficit hyperactivity disorder (ADHD). From The New York Times:
The findings suggest that in a given grade, students born at the end of the calendar year may be at a distinct disadvantage. Those perceived as having academic or behavioral problems may in fact be lagging simply as a result of being forced to compete with classmates almost a full year older than them. For a child as young as 5, a span of one year can account for 20 percent of the child’s age, potentially making him or her appear significantly less mature than older classmates.
The new study found that the lower the grade, the greater the disparity. For children in the fourth grade, the researchers found that those in the youngest third of their class had an 80 to 90 percent increased risk of scoring in the lowest decile on standardized tests. They were also 50 percent more likely than the oldest third of their classmates to be prescribed stimulants for A.D.H.D. The differences diminished somewhat over time, the researchers found, but continued at least through the seventh grade.
The new study, published in the journal Pediatrics, used data from Iceland, where health and academic measures are tracked nationally and stimulant prescription rates are high and on par with rates in the United States. Previous studies carried out there and in other countries have shown similar patterns, even among college students.
Image: Girl with prescription drugs, via Shutterstock
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Thursday, September 27th, 2012
While most parents whose low income qualifies them for health coverage through Medicaid fill prescriptions for antibiotics and other medications for acute illnesses, many fail to fill pediatricians’ orders for vitamin and mineral supplements, a new study has found. Reuters Health reports:
Antibiotics and other drugs for infections were filled 91 percent of the time, versus 65 percent of prescriptions for vitamins and minerals, for example.
“When your child has an ear infection and is in pain, you have much more of a sense of urgency,” [lead researcher Dr. Rachael] Zweigoron [of the Medical University of South Carolina in Charleston] said. But if a doctor recommends a vitamin D or iron supplement, she added, parents might not see the immediate need.
That raises the question of whether parents always know why a pediatrician has prescribed a medication or supplement. “Are we, as pediatricians, doing a good enough job of explaining the importance to parents?” Zweigoron said.
The findings, which appear in the journal Pediatrics, are based on 4,833 kids seen over two years at two clinics connected to Lurie Children’s Hospital of Chicago.
All of the children were on Medicaid, the government health insurance program for the poor. So it’s not clear if the findings would be the same for U.S. kids with private insurance.
Image: Child taking medicine, via Shutterstock
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Tuesday, July 24th, 2012
An article published in the journal Pediatrics is criticizing recent government recommendations that 9-11 year-old children have tests to screen their cholesterol levels. The Associated Press reports that one of the major critiques is that members of the government panel that made the recommendations have ties to the drug industry.
Eight of the 14 guidelines panel members reported industry ties and disclosed that when their advice was published in December. They contend in a rebuttal article in Pediatrics that company payments covered costs of evaluating whether the drugs are safe and effective but did not influence the recommendations.
It also is not uncommon for experts in their fields to have received some consulting fees from drug companies.
Even so, the ties pose a conflict of interest that “undermines the credibility of both the guidelines and the process through which they were produced,” says the commentary by researchers at the University of California at San Francisco. The authors are Dr. Thomas Newman, a researcher and former member of a Food and Drug Administration pediatrics advisory committee, and two heart disease researchers, Drs. Mark Pletcher and Stephen Hulley.
Pletcher has received research funding from drug and device makers; the other authors said they had no relevant industry ties.
Other criticism was published earlier this year in the Journal of the American Medical Association. That critique raised concerns about putting children on cholesterol drugs called statins, noting the medicine has been linked with a rare muscle-damaging condition in adults. Those authors were heart specialist Bruce Psaty and pediatrician Frederick Rivara, both of the University of Washington in Seattle.
Image: Child getting blood drawn, via Shutterstock.
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