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Significantly More Teen Girls Take Medication for Chronic Conditions Than Teen Boys
According to the data, the number of girls ages 10 to 19 on diabetes medications in total grew nearly 59 percent from 2001 to 2006 as compared to boys whose use increased by only 14 percent. However, the increase in type 2 diabetes medication use has risen a dramatic 167 percent in girls ages 10 to 19 and only 33 percent in boys the same age. There are now three and half times more girls than boys on drug therapy for type 2 diabetes, whether for treatment of type 2 diabetes or obesity related conditions.
The research, which reviewed prescription drug claims of some 370,000 girls and boys ages 10 to 19, also found the prevalence of adolescent girls taking antipsychotic drugs grew 117 percent, whereas boys that age had an increase of 71 percent. Further findings showed that 46 percent more girls than boys took sleep medications in 2006, with girls increasing their use over the past five years by over 80 percent. The increase in prevalence of girls taking ADHD medications was double that of boys, showing a 74 percent jump over the past five years, although the prevalence among boys is still greater.
"This analysis raises concerns and questions about the health of adolescents in America, and particularly girls," said Dr. Robert Epstein, Medco's chief medical officer. "While this may be evidence that more girls are for the first time being appropriately diagnosed and treated, it also raises red flags about the physical and psychological problems afflicting this population."
One hopeful sign from the data is that while the prevalence rates continue to rise, there was a significant slowing of that growth from 2005 to 2006 for girls ages 10 to 19. Over that year, the number of diabetes patients increased only 3 percent as compared to 15 percent the prior year; increases in the use of antipsychotics dropped by almost half - from 7.4 percent between 2004 to 2005 to just under 4 percent last year; and the number of ADHD patients grew a mere 0.3 percent from 2005 to 2006, significantly lower than the 4 percent increase the year before. Sleep medication use, however, grew to 12 percent from 2005 to 2006, up from 6.3 percent the prior year.
"FDA Black Box warnings and media reports about side effects over the past few years have raised public awareness of the growing use of medications among children. The associated risks may be impacting parents' and physicians' willingness to put children on these drugs," said Epstein. "When dealing with the causes of sleep disorders and type 2 diabetes, in many cases, lifestyle changes may be the first line of therapy."
For more than five years, Medco has been bringing to the public forefront pediatric prescription drug trends, issues and concerns, especially in the area of behavioral medication use. The company's vigilance in this area has contributed to a growing awareness of increased utilization of these medications among children and has been instrumental in furthering the discussion of the factors behind this development.
The slowing of growth in pediatric utilization of ADHD drugs, antipsychotics, and sleep medications from 2005 to 2006 may be a reflection of the concerns raised by reports such as the Medco research.
"Medco is dedicated to bringing this information to light to ensure pediatric patients are receiving the most appropriate treatments for their condition," said Epstein. "While drug therapy is essential for certain patients, the risks and benefits must always be weighed and, when clinically appropriate, non-drug treatments should be the initial approach."
While prevalence of diabetes as a whole continues to be on the rise, a number of recent studies suggest that type 2 diabetes is increasing dramatically. According to the New York University School of Medicine, there has been a 200 percent jump in the number of children 18 years old and younger hospitalized with type 2 diabetes between 1997 and 2003. The study showed, however, that boys are 1.3 times more likely to be hospitalized than girls, as opposed to the higher rate of girls on type 2 diabetes medication, per Medco's analysis.
The American Obesity Association reports that approximately 30 percent of children and adolescents between the ages of 6 and 19 are overweight, with about 15 percent meeting the criteria for obesity. According to Pediatrics, there are a number of reasons why adolescent girls have a greater risk of developing type 2 diabetes. Several studies suggest that girls are more insulin resistant than boys during puberty and adolescence. Sex-linked genes may also have an important impact on the development of insulin resistance and the metabolic syndrome and may help to explain the female preponderance of type 2 diabetes in children.
For patients with type 2 diabetes, disease management through lifestyle changes could lead to better control of blood glucose levels, as well as the preventing or slowing the onset of diabetes-related complications. Studies reveal that patients are most accepting of health-behavioral changes that could improve their long-term prognosis in the first 30 days of undergoing an event that requires treatment.
Through Optimal Health(R), a fully-integrated wellness and disease management collaboration between Medco and Healthways, Inc., type 2 diabetes patients are rapidly identified and proactively engaged by a staff of highly qualified nurses who, by building a partnership with the patient and facilitating communications with the treating physician, ensure optimum care and outcomes, resulting in lower health plan costs for the client. Diabetes patients also receive specialized care through a Medco Therapeutic Resource Center(TM), an advanced approach to pharmacy care that provides patients round-the-clock access to pharmacists who are specialists in treating diabetes patients.
Children are primarily being prescribed the latest generation of antipsychotics - known as atypical antipsychotics, including risperidone, olanzapine, clozapine, ziprasidone and quetiapine. These drugs have been used as treatments for bipolar disorder, conduct disorder, ADHD, depression, Tourette's syndrome and other conditions. Based on studies linking atypicals with an increased risk of hyperglycemia and diabetes, the Food and Drug Administration (FDA) requires warning labels on all these medications.
According to the National Sleep Foundation's 2006 Sleep in America poll, only 20 percent of adolescents get the recommended nine hours of sleep on school nights, and 45 percent sleep less than eight hours on school nights. Also of great concern is sleep quality -- one in 10 teens polled said they rarely or never get a good night's sleep.
A 2003 study published in Pediatrics found that 75 percent of practitioners surveyed reported recommending a non-prescription sleeping aid and 50 percent had actually prescribed one for their pediatric patients during a six month period. In addition, the study found that the likelihood of prescribing sleep medications was two-to-four times greater for those physicians who treated children with ADHD.
Although drug therapy may be beneficial for short-term improvement and long term use may be needed in some cases, the American Academy of Family Physicians cautions that long-term use of many psychotropic or sedative-hypnotic drugs may cause adverse reactions and may actually impair return to normal sleep. A combination of medication and behavioral interventions is often more effective than either approach alone for those with chronic insomnia.
The National Institute of Health (NIH) reports that ADHD affects nearly 2 million children in the United States. The most common behavioral disorder in children, ADHD is generally diagnosed during the early school years. However, approximately 75 percent of children with the condition continue to show symptoms during adolescence. Additionally, 80 percent of children who need medication for ADHD continue taking it in their teen years. ADHD is typically treated with stimulants, although some children also respond well to antidepressants.
New research out of the University of California, Berkeley found that adolescent girls with ADHD are less prone to hyperactivity than boys, but are more likely to exhibit other emotional and behavioral issues, including depression and eating disorders. Additional findings show that girls have historically been under-diagnosed with ADHD because they don't display the impulsive and disruptive behavior often seen in boys with the condition.
Source: Medco Health Solutions