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54% of children not adhering to ADHD treatment :

September 6, 2019

Less than half of children taking simulants for attention-deficit/hyperactivity disorder (ADHD) are adhering to the treatment, a study found.

Up to 11% of U.S. children have ADHD, which can have long-term consequences, but also is treatable with stimulants.

Researchers set out to see whether children prescribed stimulants are refilling their prescriptions on time. They reviewed electronic medical record data from Massachusetts General Hospital on 2,206 children ages 4-17 years who were prescribed amphetamine or methylphenidate in 2015 or 2016. Results showed 46% refilled the prescription in time to be consistently medicated.

Authors noted several predictors of adherence they said were “small but statistically significant.”

Adolescents had somewhat lower rates of adherence than younger children, possibly because parents played a larger role in making sure younger children complied, according to the study. The team also found lower rates of adherence among females.

In addition, patients who received the prescription in primary care did not adhere as well as those in a psychiatric setting, which authors said could be due to differences in ADHD severity or the influence of the prescriber.

Additional sensitivity analyses continued to find low adherence ranging from 25% when narrowing the prescription refill window to 59% when excluding patients with no recorded psychiatric diagnoses.

“While uncertainty remains as to why medication adherence is low, it is possible that low adherence is driven by the unique complexity of renewing prescriptions for stimulants, which are schedule II medicines; poor tolerability to stimulants, such as lack of appetite and difficulty sleeping; as well as ambivalence of parents about using medications to treat their children,” authors wrote.

They called for better strategies to make sure children continue to take their ADHD medications as prescribed.

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