ADHD: compliance a problem

Children with ADHD have poor adherence to medicines prescribed to treat the condition, new research has found

Researchers led by the Murdoch Children’s Research Institute published data in Archives of Disease in Childhood which show that these children go without treatment 40% of the time.

Lead author and MCRI Associate Professor Daryl Efron said medication use was relatively high in the first few months after a child was prescribed medicines to manage ADHD—but it then progressively decreased, only increasing again after five or six years of treatment.

The study showed the average medication coverage was 81% in the first 90 days dropping to 54% after 90 days.

It included data for all redeemed scripts of methylphenidate, dexamphetamine and atomoxetine between May 2002 and March 2015 from waves 1 to 6 of the Longitudinal Study of Australian Children (n=4634, age 4–5 years at wave 1), which was then analysed.

“Medication coverage was defined as the proportion of time between the first and the last redeemed prescriptions in which the child was taking medication,” the authors wrote.

“Associations between predictor variables (child sex, ADHD symptom severity, age at first prescription, family socioeconomic status (SES), single parent status, parent education and parent mental health) and medication coverage were examined using regression analyses.”

Children from socially disadvantaged families who were prescribed ADHD medication were less likely to take it consistently.

Boys were four times more likely to be prescribed ADHD medicine than girls.

“We know low socio economic families can find it more difficult to attend medical appointments, with factors including appointment costs, transport difficulties and missed work all potentially contributing,” A/Prof Efron said.

He said little had been known about the longer term adherence to medication by children with ADHD until now.

“About 90% of children with ADHD respond well to at least one of the stimulant ADHD medications,” he said.

“ADHD is a chronic condition and so there is a strong argument that treatment should be provided consistently for several years in most cases. But adherence with ADHD medications is often inconsistent.”

The authors concluded that prescribers need to continue to support families over many years to ensure medication is used consistently for children with ADHD.

“Effort should be made to continue to engage children who stop taking medications and their families to ensure they are able to access appropriate interventions, which may include medication alongside other interventions such as mental health and educational supports,” A/Prof Efron said.

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