Biomedical subjects

Jacqueline G Hugtenburg

Publications and source records attributed to Jacqueline G Hugtenburg.

5 recordsLinked to original sources

PubMed2006

Determinants of compliance with methylphenidate therapy in children.

AIM: To get more insight into factors that influence compliance with the use of methylphenidate. METHODS: 22 pharmacies detected children who used methylphenidate. Their parents were sent a questionnaire on the use of methylphenidate. In a case-control study, the influence of patient- and drug-related factors on compliance, as reported by parents, was determined. RESULTS: Parents returned 117 (75%) of 157 questionnaires sent out. Of these, 47.8% of the children missed a dose two times a month or more. Forgetting to take the medication (87.9%) was the most important reason. The case-control study showed that children of 16-18 y were more likely to miss doses. Other patient- and drug-related factors did not influence the missing of doses. CONCLUSION: A number of known determinants for compliance do not influence the missing of doses of methylphenidate. With about 80% of the parents reporting that their child missed doses of methylphenidate less than 5 times per month, compliance was quite good for the majority of the children.

Adolescent↗

PubMed2006

Parents report on stimulant-treated children in the Netherlands: initiation of treatment and follow-up care.

OBJECTIVES: The aim of this study was to describe current practices around initiation and follow-up care of stimulant treatment among stimulant-treated children in a nationwide survey among parents. METHODS: A total of 115 pharmacies detected current stimulant users <16 years old in their pharmacy information system and sent parents a questionnaire regarding their child's stimulant treatment. RESULTS: Parents returned 924 of 1,307 questionnaires (71%). The median age of the stimulant users was 10 years and 85% were boys. In all, 91% were diagnosed with attention-deficit/hyperactivity disorder (ADHD). In 77% of the cases, the child or parents received other therapies besides stimulants-21% received psychotropic co-medication, with melatonin (11%) and antipsychotics (7%) being mentioned most frequently. Stimulant use was primarily initiated by child psychiatrists (51%) and pediatricians (32%), but most children received repeat prescriptions from general practitioners (61%). Of these 924 children, 19% did not receive any follow-up care, and transfer of prescribing responsibility increased the risk of not receiving follow-up care. The 732 children (79%) who were monitored visited a physician approximately twice a year. During follow-up visits, pediatricians performed physical check ups significantly more often. CONCLUSION: Stimulant treatment in The Netherlands is initiated mainly by specialists such as child psychiatrists and pediatricians. In the current study, follow-up care for stimulant-treated children in The Netherlands appeared to be poor, suggesting an urgent need for improvement.

Adolescent↗

PubMed2005

Methylphenidate: use in daily practice.

OBJECTIVE: With the aim of getting more insight into compliance of children using methylphenidate, we studied the day-to-day use of the drug. In addition, the efficacy and side effects of treatment, stopping, switching to other drugs and the use of additional psychoactive drugs in daily practice were studied. METHOD: On the basis of pharmacy records, the use of methylphenidate by 52 children was studied. Two parameters for compliance were calculated. By means of a questionnaire, parents were asked about their children's compliance with the use of methylphenidate as well as about their experience with treatment. MAIN OUTCOME MEASURE: Compliance, use of methylphenidate in weekends and holidays, self-reported efficacy, side effects, stopping and switching to other drugs. RESULTS: Depending on the parameter calculated, the percentage of children with a good compliance varied from 25 to 47%. About 65% of the children used less or no methylphenidate in the weekends and holidays. Sixty-five percent of the parents reported to pass over a dose once in a while. According to 61% of the parents (n = 28) the efficacy of methylphenidate was good or very good. Nine (33%) of 28 children stopped using methylphenidate. Seven children stopped using the drug because of side-effects or lack of efficacy. Seven children switched to other psychoactive drugs. Fifty-seven percent of all children used additional psychoactive drugs. CONCLUSION: The percentage of children having a good compliance calculated on the basis of pharmacy records is rather low. This is partly the result of the decreased use of methylphenidate in the weekends and holidays.

Adolescent↗

PubMed2005

Complex pharmaceutical care intervention in pulmonary care: part A. The process and pharmacists' professional satisfaction.

OBJECTIVE: In the IPMP study (Interventions on the principle of Pulmonary Medication Profiles), tailored pharmaceutical care interventions were provided to pulmonary patients selected because of drug use that deviates from Dutch guidelines. The aims were to solve drug-related problems and to improve patients' drug use. This article describes the pharmaceutical care process tailored to the individual problems of patients in the intervention arm of a randomized controlled trial and defines the package of care. METHODS: After a preliminary selection of the patients with the help of the algorithmic IPMP computer instrument, instructed Dutch community pharmacists had structured consultations with patients (aged 13-70 years) in the intervention arm to identify behaviour and specific problems with their medication. Based on this identification process, a tailored intervention was constructed that could comprise one or more of six pharmaceutical care modules. Modules were clustered in sets describing the complete programme of care provided to one patient. If necessary, pharmacists consulted the patients' physicians to improve the prescribed therapy. After the interventions, medication changes were evaluated with the patients. The prescribed medication and the refill rate were monitored in the pharmacy computer during 1 year. All activities and results were extensively monitored and documented. MAIN OUTCOME MEASURE: Process description, i.e. number of provided pharmaceutical care modules and medication changes. Pharmacists' satisfaction. RESULTS: Tailored interventions were provided to 199 patients at risk of sub-optimal drug therapy. In all 813 pharmaceutical care modules were performed and documented, and clustered in four different programmes. In addition to education and motivation to adhere to prescribed medication for all 199 patients, a medication change was suggested in 124 cases. Patients and physicians agreed upon a change in 94 cases. Device change was agreed upon in 58 of 64 cases, often simultaneously with medication change. Pharmacists consulted physicians concerning 100 patients. Pharmacists reported satisfaction with the pharmaceutical care approach. CONCLUSION: Because of the extensive documentation, interventions could be described completely. Pharmacists observed a better drug use after educating patients or by solving their drug-related problems. In collaboration with physicians drug treatment could be improved.

Adolescent↗

PubMed2005

Psychoactive drug prescribing by Dutch child and adolescent psychiatrists.

AIM: To gain more insight into the prescribing of psychoactive drugs by Dutch child psychiatrists. METHODS: A questionnaire was sent to all child psychiatrists in the Netherlands. Questions were asked about the prescribing of antidepressants, antipsychotics, anxiolytics and psychostimulants for psychiatric disorders in children. RESULTS: The preference of specific antidepressants, antipsychotics and anxiolytics depends on the disorder. For different disorders, off-label prescribing varies from 19 to 71%. CONCLUSION: Preferences differ widely. Off-label drug prescribing is high. More studies on the efficacy and safety of psychoactive drugs in children are therefore required.

Adolescent↗