Enhancing ADHD Medication Adherence: Challenges and Opportunities

Abstract

Safe and effective medication for attention deficit hyperactivity disorder (ADHD) is available and recommended as first-line treatment for the core symptoms of inattention, overactivity and impulsiveness. Despite impaired functioning during adolescence, many discontinue medication treatment. For children, healthcare decisions are usually made by the parent; older youth make their own decisions. Beliefs and attitudes may differ widely. Some families understand that ADHD is a neurobiological condition and accept that medication is indicated, for others, such treatment is unacceptable. Converging evidence describes negative perceptions of the burden associated with medication use as well as concerns about potential short and long term adverse effects. Indeed experiences of adverse effects are a frequent explanation for discontinuation among youth. Ways to improve shared decision making among practitioners, parents and youth, and to monitor effectiveness, safety and new onset of concurrent difficulties are likely to optimize outcomes.

Pharmacotherapy for incident attention-deficit/hyperactivity disorder: practice patterns and quality metrics

“…Higher rates of treatment initiation with sustained release than immediate release versions of stimulants have been consistently reported 13,24,27 , likely reflecting provider, family, and patient preferences for easier-to-manage medication regimens 28 that have been associated with improved medication persistence 29,30 . Our study findings of low rates of ADHD medication persistence are similar to studies in Medicaid youth 23 , and reinforce the urgency to find effective ways of improving treatment engagement and adherence 10 , and to expand the existing quality measurement framework to capture medication persistence.…”

“…Significant concerns have also arisen over high rates of medication discontinuation, with medication persistence linked to system, patient and medication characteristics (for recent reviews, see references 9,10 ). Improved persistence has been linked to prescription through mental health specialists 11 , younger patient age 12 , and use of sustained release versions of stimulants 13 .…”

Psychoeducation for Attention Defi cit/Hyperactivity Disorder: What, How and Who Shall We Inform?

“…However, nonadherence to treatment may range from 13.2% to 64.0% (McCarthy, 2014). Among the factors that concur to nonadherence are the lack of knowledge of ADHD, medication characteristics, and treatment goals (Charach & Fernandez, 2013). Therefore, providing information about these aspects to patients and their families Psychoeducation for Attention Defi cit/Hyperactivity Disorder: What, How and Who Shall We Inform?…”

Er retningslinjene for oppfølging av AD/HD gode nok?

“…Effektevaluering, dosejustering, seponeringsforsøk og kartlegging av samsykelighet er faktorer som bør følges nøye for at man skal lykkes med behandlingen (8,9,11).…”