Trends in Prescription of Stimulants and Narcoleptic Drugs in Switzerland: Longitudinal Health Insurance Claims Analysis for the Years 2014-2021
Abstract BackgroundStimulants are potent treatments for central hypersomnolence disorders or attention-deficit/hyperactivity disorders/attention deficit disorders but concerns have been raised about their potential negative consequences and their increasing prescription rates....
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
JMIR Publications
2025-01-01
|
| Series: | JMIR Public Health and Surveillance |
| Online Access: | https://publichealth.jmir.org/2025/1/e53957 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841536234663444480 |
|---|---|
| author | Tamara Scharf Carola A Huber Markus Näpflin Zhongxing Zhang Ramin Khatami |
| author_facet | Tamara Scharf Carola A Huber Markus Näpflin Zhongxing Zhang Ramin Khatami |
| author_sort | Tamara Scharf |
| collection | DOAJ |
| description |
Abstract
BackgroundStimulants are potent treatments for central hypersomnolence disorders or attention-deficit/hyperactivity disorders/attention deficit disorders but concerns have been raised about their potential negative consequences and their increasing prescription rates.
ObjectiveWe aimed to describe stimulant prescription trends in Switzerland from 2014 to 2021. Second, we aimed to analyze the characteristics of individuals who received stimulant prescriptions in 2021 and investigate the link between stimulant prescriptions and hospitalization rates in 2021, using hospitalization as a potential indicator of adverse health outcomes.
MethodsLongitudinal and cross-sectional data from a large Swiss health care insurance were analyzed from all insureds older than 6 years. The results were extrapolated to the Swiss general population. We identified prescriptions for methylphenidate, lisdexamfetamine, modafinil, and sodium oxybate and calculated prevalences of each drug prescription over the period from 2014 to 2021. For 2021 we provide detailed information on the prescribers and evaluate the association of stimulant prescription and the number and duration of hospitalization using logistic regression models.
ResultsWe observed increasing prescription rates of all stimulants in all age groups from 2014 to 2021 (0.55% to 0.81%, 43,848 to 66,113 insureds with a prescription). In 2021, 37.1% (28,057 prescriptions) of the medications were prescribed by psychiatrists, followed by 36.1% (n=27,323) prescribed by general practitioners and 1% (n=748) by neurologists. Only sodium oxybate, which is highly specific for narcolepsy treatment, was most frequently prescribed by neurologists (27.8%, 37 prescriptions). Comorbid psychiatric disorders were common in patients receiving stimulants. Patients hospitalized in a psychiatric institution were 5.3 times (odds ratio 5.3, 95% CI 4.63‐6.08, PP
ConclusionsThe prescription of stimulant medication in Switzerland increased slightly but continuously over years, but at lower rates compared to the estimated prevalence of central hypersomnolence disorders and attention-deficit/hyperactivity disorders/attention deficit disorders. Most stimulants are prescribed by psychiatrists, closely followed by general practitioners. The increased odds for hospitalization to psychiatric institutions for stimulant receivers reflects the severity of disease and the higher psychiatric comorbidities in these patients. |
| format | Article |
| id | doaj-art-225b38ade5294b289f38b603c3ece9b8 |
| institution | Kabale University |
| issn | 2369-2960 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | JMIR Public Health and Surveillance |
| spelling | doaj-art-225b38ade5294b289f38b603c3ece9b82025-01-14T21:36:27ZengJMIR PublicationsJMIR Public Health and Surveillance2369-29602025-01-0111e53957e5395710.2196/53957Trends in Prescription of Stimulants and Narcoleptic Drugs in Switzerland: Longitudinal Health Insurance Claims Analysis for the Years 2014-2021Tamara Scharfhttp://orcid.org/0000-0002-4958-4356Carola A Huberhttp://orcid.org/0000-0002-2469-0435Markus Näpflinhttp://orcid.org/0009-0009-2213-0424Zhongxing Zhanghttp://orcid.org/0000-0003-0184-8882Ramin Khatamihttp://orcid.org/0000-0002-1092-6160 Abstract BackgroundStimulants are potent treatments for central hypersomnolence disorders or attention-deficit/hyperactivity disorders/attention deficit disorders but concerns have been raised about their potential negative consequences and their increasing prescription rates. ObjectiveWe aimed to describe stimulant prescription trends in Switzerland from 2014 to 2021. Second, we aimed to analyze the characteristics of individuals who received stimulant prescriptions in 2021 and investigate the link between stimulant prescriptions and hospitalization rates in 2021, using hospitalization as a potential indicator of adverse health outcomes. MethodsLongitudinal and cross-sectional data from a large Swiss health care insurance were analyzed from all insureds older than 6 years. The results were extrapolated to the Swiss general population. We identified prescriptions for methylphenidate, lisdexamfetamine, modafinil, and sodium oxybate and calculated prevalences of each drug prescription over the period from 2014 to 2021. For 2021 we provide detailed information on the prescribers and evaluate the association of stimulant prescription and the number and duration of hospitalization using logistic regression models. ResultsWe observed increasing prescription rates of all stimulants in all age groups from 2014 to 2021 (0.55% to 0.81%, 43,848 to 66,113 insureds with a prescription). In 2021, 37.1% (28,057 prescriptions) of the medications were prescribed by psychiatrists, followed by 36.1% (n=27,323) prescribed by general practitioners and 1% (n=748) by neurologists. Only sodium oxybate, which is highly specific for narcolepsy treatment, was most frequently prescribed by neurologists (27.8%, 37 prescriptions). Comorbid psychiatric disorders were common in patients receiving stimulants. Patients hospitalized in a psychiatric institution were 5.3 times (odds ratio 5.3, 95% CI 4.63‐6.08, PP ConclusionsThe prescription of stimulant medication in Switzerland increased slightly but continuously over years, but at lower rates compared to the estimated prevalence of central hypersomnolence disorders and attention-deficit/hyperactivity disorders/attention deficit disorders. Most stimulants are prescribed by psychiatrists, closely followed by general practitioners. The increased odds for hospitalization to psychiatric institutions for stimulant receivers reflects the severity of disease and the higher psychiatric comorbidities in these patients.https://publichealth.jmir.org/2025/1/e53957 |
| spellingShingle | Tamara Scharf Carola A Huber Markus Näpflin Zhongxing Zhang Ramin Khatami Trends in Prescription of Stimulants and Narcoleptic Drugs in Switzerland: Longitudinal Health Insurance Claims Analysis for the Years 2014-2021 JMIR Public Health and Surveillance |
| title | Trends in Prescription of Stimulants and Narcoleptic Drugs in Switzerland: Longitudinal Health Insurance Claims Analysis for the Years 2014-2021 |
| title_full | Trends in Prescription of Stimulants and Narcoleptic Drugs in Switzerland: Longitudinal Health Insurance Claims Analysis for the Years 2014-2021 |
| title_fullStr | Trends in Prescription of Stimulants and Narcoleptic Drugs in Switzerland: Longitudinal Health Insurance Claims Analysis for the Years 2014-2021 |
| title_full_unstemmed | Trends in Prescription of Stimulants and Narcoleptic Drugs in Switzerland: Longitudinal Health Insurance Claims Analysis for the Years 2014-2021 |
| title_short | Trends in Prescription of Stimulants and Narcoleptic Drugs in Switzerland: Longitudinal Health Insurance Claims Analysis for the Years 2014-2021 |
| title_sort | trends in prescription of stimulants and narcoleptic drugs in switzerland longitudinal health insurance claims analysis for the years 2014 2021 |
| url | https://publichealth.jmir.org/2025/1/e53957 |
| work_keys_str_mv | AT tamarascharf trendsinprescriptionofstimulantsandnarcolepticdrugsinswitzerlandlongitudinalhealthinsuranceclaimsanalysisfortheyears20142021 AT carolaahuber trendsinprescriptionofstimulantsandnarcolepticdrugsinswitzerlandlongitudinalhealthinsuranceclaimsanalysisfortheyears20142021 AT markusnapflin trendsinprescriptionofstimulantsandnarcolepticdrugsinswitzerlandlongitudinalhealthinsuranceclaimsanalysisfortheyears20142021 AT zhongxingzhang trendsinprescriptionofstimulantsandnarcolepticdrugsinswitzerlandlongitudinalhealthinsuranceclaimsanalysisfortheyears20142021 AT raminkhatami trendsinprescriptionofstimulantsandnarcolepticdrugsinswitzerlandlongitudinalhealthinsuranceclaimsanalysisfortheyears20142021 |