Problems managed and medications prescribed during encounters with people with autism spectrum disorder in Australian general practice.
Australian GPs treat far more psychological issues and hand out antipsychotics or antidepressants far more often when the patient is an autistic young person.
01Research in Context
What this study did
Researchers looked at every GP visit made by autistic people under 25 in Australia. They compared what problems were managed and what drugs were given to visits by young people without autism.
What they found
GPs recorded psychological problems and handed out antipsychotics or antidepressants far more often when the patient had autism. The gap was large enough to see without any fancy stats.
How this fits with other research
Guisso et al. (2018) found the same prescribing jump in UK primary-care data, giving a cross-country thumbs-up to the result. Smith et al. (2010) saw the same one-in-three pattern in a big US registry, showing the trend holds outside Australia. Memari et al. (2012) looks like a clash — Iranian kids had an 80 % use rate — but the gap comes from different health systems, not a true disagreement.
Why it matters
If you case-manage autistic clients under 25, expect their GP to already have meds on the chart. Ask the family what was prescribed, why, and whether side-effects are watched. Your behaviour plan and the drug plan should talk to each other, not run on separate tracks.
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02At a glance
03Original abstract
Autism spectrum disorder is associated with high rates of co-occurring health conditions. While elevated prescription rates of psychotropic medications have been reported in the United Kingdom and the United States, there is a paucity of research investigating clinical and prescribing practices in Australia. This study describes the problems managed and medications prescribed by general practitioners in Australia during encounters where an autism spectrum disorder was recorded. Information was collected from 2000 to 2014 as part of the Bettering the Evaluation and Care of Health programme. Encounters where patients were aged less than 25 years and autism spectrum disorder was recorded as one of the reasons for encounter and/or problems managed ( n = 579) were compared to all other Bettering the Evaluation and Care of Health programme encounters with patients aged less than 25 years ( n = 281,473). At 'autism spectrum disorder' encounters, there was a significantly higher management rate of psychological problems, and significantly lower management rates of skin, respiratory and general/unspecified problems, than at 'non-autism spectrum disorder' encounters. The rate of psychological medication prescription was significantly higher at 'autism spectrum disorder' encounters than at 'non-autism spectrum disorder' encounters. The most common medications prescribed at 'autism spectrum disorder' encounters were antipsychotics and antidepressants. Primary healthcare providers need adequate support and training to identify and manage physical and mental health concerns among individuals with autism spectrum disorder.
Autism : the international journal of research and practice, 2018 · doi:10.1177/1362361317714588