Medical treatment of children and youths with attention-deficit/hyperactivity disorder (ADHD): a Norwegian Prescription Registry Based Study.

OBJECTIVES: Attention-deficit/hyperactivity disorder (ADHD) is a lifelong neurological condition with a profound effect on quality of life. Prescription databases may document pattern of use. In this study we aimed to explore the use in Norway employing such a database. METHODS: All prescriptions on drugs for the treatment of ADHD between 2004 and 2011, as registered in the Norwegian Prescription Database (NPD) were analyzed. The following drugs were included: Amphetamine, dexamphetamine, methylphenidate and atomoxetine. In-hospital drug administration was excluded. Numbers of users per 1,000 inhabitants were calculated according to gender, age and residence. A sub-analysis compared users born in January-June with those born in July-December. Drug costs were calculated and converted into Euros (€ 1 = N.kr 7.4540). RESULTS: Drugs for the treatment of ADHD was significantly more often prescribed in northern Norway than in any other Norwegian health region (P < 0.001). Within the northern region, Nordland County was the "culprit" (P < 0.02). Compared to Norwegian figures, significantly more females (aged 10-19 years) were treated in northern Norway [male/female ratios 3:1 and 2.2:1 (P < 0.01)] and especially in Nordland County (ratio 2.1:1). The subanalysis did not indicate a northern overtreatment of those being a younger group in their grade. The annual drug cost per user in Norway was € 919. CONCLUSIONS: The prescription rate was significantly higher in northern Norway and Nordland County was the culprit. A prescription database may be a tool for monitoring the national use of these drugs.

Compulsory and voluntary admission in psychiatric hospitals in northern Norway 2009-2010. A national registry-based analysis.

BACKGROUND: During the last decade, Norwegian healthcare authorities have been concerned about the frequent use of coercive measures in psychiatric care. On this background, we aimed to explore the voluntary and compulsory admissions in psychiatric hospitals in northern Norway, the University Hospital of North Norway in Tromsø (UNN-T) and the Nordland Hospital in Bodø (NH-B). METHODS: All voluntary and compulsory admissions (2009-2010) among patients aged ≥18 years registered by the Norwegian Patient Registry (NPR) were analyzed retrospectively. Compulsory admission was registered according to the general practitioner's (GP's) decision and the patients were hospitalized in Bodø or Tromsø. A total of 12,237 admissions and 242,148 days in hospital were identified. The female/male ratio of admission and stay was 1.17 and 1.15, respectively. RESULTS: The admission rate (northern Norway =1.0) varied significantly from south to north (0.60-1.52). Whereas patients living close to the hospitals had the same admission rate as others, the mean hospital stay was significantly longer (ratio =1.32). Furthermore, the UNN-T had a higher re-admission rate (2% vs. 5%). Municipalities with District Psychiatric Centers (DPC) did not differ from others. A significant difference in the use of coercive measures was revealed between hospitals. Forced medication was the most frequent measure employed. CONCLUSIONS: The study documented a south-north gradient in admission rate and indicated differences in the use of coercion. Variation may partly be due to different reporting procedures. This finding and why patients living in the neighborhood of hospitals stay longer should be explored in future studies.

Admission and stay in psychiatric hospitals in northern Norway among Sami and a control group: a registry-based study.

BACKGROUND: The aim of this study was analyze the admission and inpatient stay at psychiatric hospital in northern Norway among people from the Sami-speaking municipalities (Sami group) and a control group (non-Sami group). Are they treated equally? METHODS: All admissions and inpatient stay from the administration area of the Sami language law (eight municipalities) was matched with a control group of 11 municipalities. All adult patients treated during the 2-year time period 2009-2010 and registered by the Norwegian Patient Registry (NPR) were included in the study. Population data as of 2009 was accessed from Statistics Norway. The admission rate and the days in hospital (DiH) rate per 10,000 inhabitants/year were set as 1.0. RESULTS: Both study groups had a significantly higher admission and DiH-rate than northern Norwegians in general. The median annual admission rate/10,000 inhabitants was 284 (Sami) and 307 (non-Sami), respectively (P = 0.23). Whereas there were no difference between groups with regard to DiH/10,000 inhabitants/year (P = 0.24), the males of the Sami group spent significantly fewer DiH when any form of coercion was used (RR = 0.41). CONCLUSIONS: Sami did not experience significantly more or fewer admissions (voluntary and compulsory) to psychiatric hospitals than the control group. There were significant intergroup variations in both groups.

Health consumption in Sami-speaking municipalities with regard to cancer and radiotherapy.

OBJECTIVES: The objective of this study was to document that the Sami people, constituting an ethnic minority in northern Norway, experience an equally available specialist health care service as the one offered to Norwegians in general. We aimed to use cancer and radiotherapy treatment as the instrument to clarify the situation. STUDY DESIGN: A retrospective registry-based study. METHODS: The 8 municipalities included in the administration area of the Sami language law were matched with a control group of 11 municipalities. Population data (numbers, sex and age) were accessed from Statistics Norway. Data on cancer incidence, prevalence and survival during the 10-year time period 1999-2008 were derived from the Cancer Registry of Norway (CRN). Five years overall survival was calculated for patients diagnosed in the time period 1999-2003. Furthermore, data on radiotherapy (RT) and treatment intention were recorded for the time period 1999-2008. RESULTS: The Sami-speaking municipalities had a significantly lower incidence of cancer. Breast (RR 0.82 [95% CI 0.76-0.89]) and lung cancer (females RR 0.55 [95% CI 0.52-0.58], males RR 0.64 [95% CI 0.60-0.68]) were significantly less frequent. The Sami group had experienced a significant increase (Sami 54.5% [95% CI 49.2-61.7], controls 24.1% [95% CI 21.7-26.5]) in the prevalence of cancer during the last 10 years. Five years overall survival was similar among both the Sami and control groups. In both groups, 28% of cancer patients underwent radiotherapy. CONCLUSIONS: The Sami in northern Norway had a lower risk of cancer but experienced the same use of radiotherapy in their cancer treatment as Norwegians in general.