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Paediatric psychotropic prescribing practices in Ireland

Published online by Cambridge University Press:  28 January 2014

F. McNicholas ,
N. Orakwue-Ononye  and
S. O’Hanrahan
F. McNicholas*
Affiliation:
Lucena Clinic, Rathgar, Dublin, Ireland Our Lady’s Children’s Hospital, Crumlin, University College Dublin, Ireland
N. Orakwue-Ononye
Affiliation:
Foothills Medical Center NW, Calgary, Canada
S. O’Hanrahan
Affiliation:
Lucena Clinic, Rathgar, Dublin, Ireland
*
*Address for correspondence: F. McNicholas, Consultant Child Psychiatrist and Professor of Child Psychiatry, Lucena Clinic, Rathgar, Dublin 6, Ireland. (Email: Fiona.mcnicholas@sjog.ie)
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Abstract

Objectives

This study describes the attitudes, knowledge and prescribing of psychotropic medication in children.

Method

A study-specific questionnaire was mailed to all child psychiatrists, paediatricians and a group of registered general practitioners (GPs) from a selected Child and Adolescent Mental Health Services catchment area.

Results

In the 116 respondents who replied (39% response rate), psychotropic medication was generally valued and used by all groups (70.1%). Respondents believed that the majority (61.9%) of their non-medical colleagues would also value/support the use of medication and this endorsement influenced the respondents’ prescribing rates. Initiating medication was viewed as the province of child psychiatry (78.6%). Medication is felt to be justified in a wide variety of mental health disorders, their use being reserved for severe presentations, with psychostimulants and selective serotonin reuptake inhibitors being most used. A significant number of GPs (60.9%) and paediatricians (63.4%) were felt to be lacking in competence in psychotropic prescribing, with a general request for more seminars in this area (61.5%) with almost half (45%) of them believing that they would prescribe more often.

Conclusion

The use of psychotropic medication in children remains a valued and common practice in Ireland. Attitudinal and practice differences across professional groups exist, and although the experience is one of relative safety there was a strong desire for further education leading to a perceived increase in utilisation. The impact of perceived public opinion regarding psychotropic prescribing along with a lack of competence may represent a major barrier to effective prescribing, thus highlighting the importance of ongoing professional development and increased public health initiatives to increase knowledge and understanding in this increasingly important area.

Keywords

childrenpsychotropic medicationprescribing practices
Type
Original Research
Information
Irish Journal of Psychological Medicine , Volume 31 , Issue 1 , March 2014 , pp. 7 - 20
Copyright
© College of Psychiatrists of Ireland 2014 

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