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CMAJ
CMAJ - February 8, 2000JAMC - le 8 février 2000

Caveat lector: be wary of media reports about excessive Ritalin use in BC

CMAJ 2000;162:313

See also:
A newspaper recently claimed that in 1998, children in some parts of British Columbia were being prescribed methylphenidate (Ritalin) at the highest known rate in North America.1 This is untrue. The newspaper reported that 10 548 children aged 19 or younger (1% of children in this age group) had received at least one prescription for methylphenidate during the year. The article also identified areas of the province where it said up to 30% of children in some age groups received methylphenidate.

To investigate these claims, we submitted a request to PharmaNet, BC's comprehensive prescription drug database, for a count by local health area (LHA) of patients aged 19 or younger who had filled at least one of these prescriptions in 1998. The province has 88 LHAs.

Contrary to data used by the newspaper, we found that methylphenidate use in 1998 was either lower than or consistent with numbers previously reported for other North American jurisdictions.2,3 Overall, methylphenidate was prescribed to 1% of BC residents aged 19 years of age and younger. Use was highest in the 10- to 14-year age group (2.1%). Variation in use of the drug across regions was also much smaller than reported by the newspaper. The difference between the highest and lowest regional rates reported in article was 18.8 percentage points. We found that the range of methylphenidate use in the 10- to 14-year age group was actually a fraction of the ranges cited by the newspaper, ranging from 0% to 4.9% across regions.

The newspaper reported that 10 548 BC residents were taking methylphenidate between Feb. 1, 1998, and Feb. 1, 1999. This was close to our finding of 10 742 patients for calendar year 1998. Why the difference in usage rates? This likely occurred because 1996 Statistics Canada population data used in the media article did not include the entire populations of the regions examined. These underestimates involving source populations may have inflated utilization rates used by the newspaper.

We think our analysis carries an important message: verify media reports before forming conclusions about utilization patterns for prescription drugs.

Colin Dormuth
Pharmacare
BC Ministry of Health
Victoria, BC
John F. Anderson
Clinical Support Unit
BC Ministry of Health
Victoria, BC
john.anderson@moh.hnet.bc.ca
Leanne Warren
Pharmacare
BC Ministry of Health
Victoria, BC

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References

  1. Rees A. When it comes to kids taking Ritalin, BC's breaking records. Vancouver Province 1999 Aug 9;Sect A:15.
  2. Goldman LS, Genel M, Bezman RJ, Slanetz PJ. Diagnosis and treatment of attention-deficit/hyperactivity disorder in children and adolescents. JAMA 1998;279(14):1100-7. [MEDLINE]
  3. Ivis FJ, Adlaf EM. Prevalence of methyl-phenidate use among adolescents in Ontario. Can J Public Health 1999;90:309-12. [MEDLINE]

© 2000 Canadian Medical Association or its licensors