ADHD medication use, adherence, persistence and cost among Texas Medicaid children

Abstract

ADHD medication adherence and persistence was suboptimal. Although there was no difference in adherence between long-acting stimulant and non-stimulant users, non-stimulant users were more persistent compared to stimulant users. This study was limited due to the use of retrospective prescription claims data, which cannot capture actual patient use patterns, ICD-9 diagnoses, family history and support, or side effect profiles. Because ADHD can be effectively treated with pharmacotherapy, providers should be proactive in identifying patients with poor adherence and intervene to address barriers to medication adherence and persistence.

Treatment adherence in Asthma and Attention Deficit Hyperactivity Disorder (ADHD), Personality traits, Beliefs about medication and Illness perception

“…The younger individuals with asthma showed lower adherence to medication than the older ones in the age span between 12 to 65 years old (Taylor et al, 2014), in one study, but the opposite directions emerged in another asthma population with age range between 29 to 96 years old (Darba et al, 2016). Moreover, amongst adolescents between 11 and 16 years of age, the younger individuals in the group showed higher adherence (Mosnaim et al, 2014), in agreement with findings on young people with ADHD (Barner et al, 2011;Faraone et al, 2007). Accordingly, WHO pointed out that separate evaluations are required for every disease and for different age groups at varying developmental stages (Sabaté, 2003).…”

“…For instance, no gender differences regarding adherence behaviour were detected in a study on asthma (Axelsson et al, 2015), whereas lower adherence to medication was revealed in boys compared to girls between 3-18 years old with ADHD (Barner et al, 2011).…”

“…Inhaled long-acting β2-agonist substances have yielded higher adherence than inhaled corticosteroids (Murphy et al, 2012). In ADHD, adherence to immediaterelease stimulants is less than to non-stimulant treatment (Barner et al, 2011).…”

“…This is a concern, because some studies have found that about 50% of those on prescribed medication are reported to not adhere to the pharmacological therapy recommended by health care providers (Sabaté, 2003). Adherence behaviour varies between different disorders (Gatti, Jacobson, Gazmararian, Schmotzer, & Kripalani, 2009; and age groups, although somewhat inconsistently (Barner, Khoza, & Oladapo, 2011;Darba et al, 2016;Faraone, Biederman, & Zimmerman, 2007;Mosnaim et al, 2014;Taylor, Chen, & Smith, 2014). This explains the recommendation of World Health Organization (WHO), which claims that adherence assessment is needed for every disorder and developmental stage (Sabaté, 2003).…”

An Observational Study of Pharmacological Treatment in Primary Care of Children With ADHD in the United Kingdom

“…Specifically, medication persistence, defined as the duration of time from initiation to discontinuation of drug therapy (10), has been estimated as less than six months for stimulants (12)(13)(14)(15)(16). Given the chronic nature of ADHD, long-term ADHD treatment effectiveness may be complicated by poor medication adherence (17).…”