국민건강보험 데이터베이스를 이용한 한국의 소아와 성인에서 주의력결핍 과잉행동장애의 진단율 및 약물 사용 추세 연구
The Diagnostic Rate and Drug Use Trend of Attention Deficit Hyperactivity Disorder Among Children and Adults in Korea Using the National Health Insurance Database
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초록
Objectives Attention deficit/hyperactivity disorder (ADHD) is a condition characterized by inattention or hyperactivity and impulsivity that hinders function and development. The purpose of this study was twofold, that is, to check the diagnostic rate of ADHD, which is first diagnosed in adulthood as well as in childhood, and to compare drugs prescribed to children and adult patients. Methods This study utilized Health Insurance Review & Assessment Service data from 1 January 2009 to 31 December 2018. Only first entered International Classification of Diseases diagnostic codes were collected. We set the first year as a clearance period, checked changes in drug prescriptions over the years, and investigated differences found between pediatric and adult patients. Results The overall diagnostic rate of ADHD decreased from 71.9 to 69.7 per 100000 people between 2009 and 2012. This reducing trend was noticeable from 2012 and decreased to 43.7 by 2015, and then rose again to 65.4 in 2018. Extended-release formulation of the methylphenidate (ER-MPH) was found to be the most frequently used first drug. Conclusion Overall diagnostic rate decreased from 2009 to 2018, and the incidence of adult ADHD showed a steady increase. For children, ER-MPH was the most prescribed drug at all ages, while osmotic-release oral system formulation of the methylphenidate was most prescribed for adults.
Abstract
Objectives Attention deficit/hyperactivity disorder (ADHD) is a condition characterized by inattention or hyperactivity and impulsivity that hinders function and development. The purpose of this study was twofold, that is, to check the diagnostic rate of ADHD, which is first diagnosed in adulthood as well as in childhood, and to compare drugs prescribed to children and adult patients. Methods This study utilized Health Insurance Review & Assessment Service data from 1 January 2009 to 31 December 2018. Only first entered International Classification of Diseases diagnostic codes were collected. We set the first year as a clearance period, checked changes in drug prescriptions over the years, and investigated differences found between pediatric and adult patients. Results The overall diagnostic rate of ADHD decreased from 71.9 to 69.7 per 100000 people between 2009 and 2012. This reducing trend was noticeable from 2012 and decreased to 43.7 by 2015, and then rose again to 65.4 in 2018. Extended-release formulation of the methylphenidate (ER-MPH) was found to be the most frequently used first drug. Conclusion Overall diagnostic rate decreased from 2009 to 2018, and the incidence of adult ADHD showed a steady increase. For children, ER-MPH was the most prescribed drug at all ages, while osmotic-release oral system formulation of the methylphenidate was most prescribed for adults.
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