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The association between the use of parents' and childrens' medication.

Dijk, L. van, Cardol, M. The association between the use of parents' and childrens' medication. European Journal of Public Health: 2005, 15(Suppl. 1) 174. Abstract. 13th Annual EUPHA Meeting "Promoting the public's health: reorienting health policies, linking health promotion and health care", Graz, 10-12 November 2005.
Background: Family background influences medical consumption. For example, 22% of the variance in
frequencies of contact with the GP in The Netherlands can be ascribed to family influence. Up to now
not much is known about family influence in one particular area of medical consumption: the use of
(prescribed) medication. The difference between visiting the GP and the use of prescribed medication
is that the role of the GP is more important in prescription: the ultimate decision to prescribe is
taken by the GP, while the ultimate decision to visit the GP is usually taken by the parent(s). The
aim of this study is to examine the association between the use of prescribed medication of parents
and their children. Methods: Data were used from over 10 000 two-parent families with children under
the age of 12 from the Second Dutch National Survey of General Practice. For a one-year period all
contacts with the GP and all prescribed medication were registered in 104 general practices in 2001.
Moreover, all patients filled out a census form including 10 questions on for example, educational
level, health status, and type of insurance. These data were linked with the GP registration data.
Data were analysed using multilevel analyses to take into account clustering of the data. The
outcomes variable was the child’s number of prescriptions. Explanatory variables include
characteristics of the children (e.g. age, gender, and health status) and parental characteristics
(number of prescriptions and health status). Results: Differences in use beween different groups of
children (f.e. girls versus boys) could mainly be explained by differences in consultation rates
between these groups. The use of prescribed medication of parents and children was associated.
Within the group of families where both parents did not use prescribed medication 31% of the
children received prescriptions as against 61% of the children in families where both parents used
prescribed medication. The correlation between the number of prescriptions of children and parents
was stronger for mothers (r = 0.21) compared to fathers (0.15). Although the correlation was not
strong it remained significant in the multilevel analyses where we controlled for child’s
characteristics such as health status and contact frequency as well as for parental characteristics
such as health status. This analysis was only performed for those children being at risk for
prescription that is those children who visited their GP at least once during the year of
registration. Conclusions: The use of medication by children is associated with their parents’ use.
Health status, frequency of GP consultation and other child- and parent characteristics cannot fully
explain this association. This finding is interesting since the GP is the one who ultimately decides
whether or not to prescribe. Apparently GPs’ prescription behaviour is influenced by the family
context of individual patients. (aut.ref.)
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