The use of medication against attention deficit/hyperactivity disorder in Denmark: a drug use study from a patient perspective

Pottegård, Anton; Bjerregaard, Bine Kjøller; Glintborg, Dorte; Kortegaard, Lisbeth Sandal; Hallas, Jesper; Moreno, Søren Ilsøe

doi:10.1007/s00228-012-1344-0

Cited by 45 publications

(54 citation statements)

References 41 publications

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“…One important result was the extensive increase of MPH dispensing from 2005 to 2011. This trend has already been described by different drug utilization studies in other European countries [6,7,9,28,29] . An extensive variability was observed in the European levels between 2002 and 2010, for example, +425% in Denmark (0.8-4.2 DDD/1,000 inhabitants/day), +67% in France (0.18-0.3 DDD/1,000 inhabitants/day), +116% in Germany (1-2.16 DDD/1,000 inhabitants/day), and +122% in the Netherlands (2.04-4.53 DDD/1,000 inhabitants/day) [28] .…”

Section: Discussionmentioning

confidence: 72%

Patterns of Methylphenidate Use and Assessment of Its Abuse among the General Population and Individuals with Drug Dependence

Frauger¹,

Amaslidou²,

Spadari³

et al. 2015

Eur Addict Res

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Purpose: The aim of this study was to describe the extent of methylphenidate (MPH) abuse and characterize its patterns by following several cases involving intravenous administration of crushed MPH tablets. Methods: First, a drug reimbursement database (covering 4 million inhabitants) was explored to assess the magnitude of MPH abuse among the general population, and second, a specific study based on individuals with drug dependence was performed to describe abusers' characteristics (n = 64), patterns of abuse and clinical implications. Results: From 2005 to 2011, the number of patients who were dispensed MPH at least once increased by 166%. The patients with ‘deviant' patterns of MPH consumption were mainly male adults with opiate maintenance treatment reimbursements. MPH abusers had precarious living conditions. Half of them consumed MPH daily by intravenous route and reported amphetamine-like effects (cardiovascular events, weight loss, psychiatric adverse events). Conclusion: Given the increase of MPH use, it is important to warn the scientific community about possible MPH abuse, especially in individuals with drug dependence. This study has facilitated public health intervention and dissemination of information related to MPH abuse among health care professionals at local and national levels.

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Section: Discussionmentioning

confidence: 72%

Patterns of Methylphenidate Use and Assessment of Its Abuse among the General Population and Individuals with Drug Dependence

Frauger¹,

Amaslidou²,

Spadari³

et al. 2015

Eur Addict Res

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“…Of these studies, eleven reported discontinuation rates among combined groups of children, adolescents, and adults, one study focused on adults only,28 and 25 studies focused on children and adolescents only. Three studies29–31 reported results separately for those patients who were 18 years and under and for those >18 years of age.…”

Section: Resultsmentioning

confidence: 99%

Adherence, persistence, and medication discontinuation in patients with attention-deficit/hyperactivity disorder – a systematic literature review

Gajria¹,

Li²,

Sikirica³

et al. 2014

NDT

126

102

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Untreated attention-deficit/hyperactivity disorder (ADHD) can lead to substantial adverse social, economic, and emotional outcomes for patients. The effectiveness of current pharmacologic treatments is often reduced, due to low treatment adherence and medication discontinuation. This current systematic literature review analyzes the current state of knowledge surrounding ADHD medication discontinuation, focusing on: 1) the extent of patient persistence; 2) adherence; and 3) the underlying reasons for patients’ treatment discontinuation and how discontinuation rates and reasons vary across patient subgroups. We selected 91 original studies (67 with persistence/discontinuation results, 26 with adherence results, and 41 with reasons for discontinuation, switching, or nonadherence) and 36 expert opinion reviews on ADHD medication discontinuation, published from 1990 to 2013. Treatment persistence on stimulants, measured by treatment duration during the 12-month follow-up periods, averaged 136 days for children and adolescents and 230 days for adults. Owing to substantial study heterogeneity, comparisons across age or medication type subgroups were generally inconclusive; however, long-acting formulations and amphetamines were associated with longer treatment duration than short-acting formulations and methylphenidates. The medication possession ratio, used to measure adherence, was <0.7 for all age groups and medication classes during a 12-month period. Adverse effects were the most commonly cited reason for discontinuation in all studies. Original research studies reported the lack of symptom control as a common discontinuation reason, followed by dosing inconvenience, social stigma associated with ADHD medication, and the patient’s attitude. In summary, although there was a lack of consistency in the measurement of adherence and persistence, these findings indicate that drug adherence and persistence are generally poor among patients with ADHD. Clinicians may be able to help improve adherence and persistence to ADHD treatment by educating caregivers and patients on treatment goals, administering long-acting medications, and following-up with patients to verify if medication is still effective and well-tolerated.

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“…Data published in different European countries (Finland, Iceland, Denmark, Norway, Sweden, Spain and Germany) exhibit the same trend. [10][11][12][13] A study detailing the OSIAP data on falsified prescriptions on European level showed that methylphenidate had the highest rates of falsification in Spain and Belgium. [14] Cases of methylphenidate abuse have been reported in Switzerland [15][16][17] and Iceland, where patients had a similar profile to that observed in the PACA region in France: a population using intravenous injection, polysubstance abusers and in a precarious socio-economic situation [18] .…”

Section: Methylphenidate: Is There a Link Between Accessibility And Amentioning

confidence: 99%

Example of an Investigation of an “Emergent” Phenomenon in Addiction Vigilance: the Case of Methylphenidate

et al. 2015

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-Abuse of and addiction to medication are a major public health issue which is evolving fast, in particular in countries like France, one of the largest consumers of medication in Europe. As a single source of information is not generally sufficient to measure a phenomenon as difficult to apprehend as medication-related addiction, as can be seen in the case of methylphenidate, it is essential to mobilise all the tools available, here surveillance programmes developed by the French CEIP Addiction vigilance network, such as suspicious prescriptions indicating possible abuse data (OSIAP) or observatory of illegal or misused psychoactive medications (OPPIDUM), as well as the health insurance databases, and health professional sentinel networks. The latest data available on methylphenidate abuse in France suggests a stabilisation of the phenomenon, which emerged in the Provence-Alpes-Côte-d'Azur (PACA) region in southern France. It also evidences its diffusion to other regions, so that the information needs to be widely relayed, and suggests that health professionals should exercise the greatest caution in the use of this substance, and should look for early signs of its misuse.Abbreviations: see end of article.

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The use of medication against attention deficit/hyperactivity disorder in Denmark: a drug use study from a patient perspective

Abstract: We found certain traits that warrant further investigation: the apparent increase in average daily doses, the low adherence to treatment among off-label users, and the increased use of other psychotropic medication.

Cited by 45 publications

References 41 publications

Patterns of Methylphenidate Use and Assessment of Its Abuse among the General Population and Individuals with Drug Dependence

Patterns of Methylphenidate Use and Assessment of Its Abuse among the General Population and Individuals with Drug Dependence

Adherence, persistence, and medication discontinuation in patients with attention-deficit/hyperactivity disorder – a systematic literature review

Example of an Investigation of an “Emergent” Phenomenon in Addiction Vigilance: the Case of Methylphenidate

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The use of medication against attention deficit/hyperactivity disorder in Denmark: a drug use study from a patient perspective

Abstract: We found certain traits that warrant further investigation: the apparent increase in average daily doses, the low adherence to treatment among off-label users, and the increased use of other psychotropic medication.

Cited by 45 publications

References 41 publications

Patterns of Methylphenidate Use and Assessment of Its Abuse among the General Population and Individuals with Drug Dependence

Patterns of Methylphenidate Use and Assessment of Its Abuse among the General Population and Individuals with Drug Dependence

Adherence, persistence, and medication discontinuation in patients with attention-deficit/hyperactivity disorder &ndash; a systematic literature review

Example of an Investigation of an “Emergent” Phenomenon in Addiction Vigilance: the Case of Methylphenidate

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Adherence, persistence, and medication discontinuation in patients with attention-deficit/hyperactivity disorder – a systematic literature review