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Adherence with electronic monitoring and symptoms in children with attention deficit hyperactivity disorder

Jaewon Yang1, Byung-Moon Yoon, Moon-Soo Lee

  • 1Department of Psychiatry, Korea University College of Medicine, Ansan Hospital, Ansan, Republic of Korea. ; Korea University Research Institute of Mental Health, Seoul, Republic of Korea.

Psychiatry Investigation
|September 21, 2012
PubMed

Insights

Electronic monitoring via MEMS revealed higher non-adherence rates for ADHD medication compared to other methods. Adherence levels did not correlate with symptom severity or improvement in children with ADHD.

Area of Science:

  • Pediatric Psychiatry
  • Neuroscience
  • Clinical Pharmacology

Background:

  • Attention-deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children.
  • Medication adherence is crucial for effective ADHD management, particularly with stimulant medications like methylphenidate.
  • Accurate assessment of adherence is challenging but essential for treatment success.

Purpose of the Study:

  • To compare the accuracy of electronic monitoring (Medication Event Monitoring System - MEMS) against traditional adherence measures for Osmotic-controlled Release Oral delivery System methylphenidate in children with ADHD.
  • To explore the relationship between medication adherence and clinical factors, including ADHD symptom severity and treatment response.

Main Methods:

  • A cohort of 39 children diagnosed with ADHD participated in an eight-week study.
  • Medication adherence was assessed using MEMS, patient self-report, clinician ratings, and pill counts.
  • Demographic, clinical characteristics, and ADHD symptom ratings were collected and analyzed.

Main Results:

  • The MEMS identified a significantly higher non-adherence rate (46.2%) compared to patient self-report (17.9%), clinician rating (31.7%), and pill count (12.8%).
  • MEMS-measured adherence did not show a significant association with baseline ADHD symptom severity or symptom improvement over time.
  • Children in the non-adherent group (by MEMS) exhibited more severe baseline symptoms and less improvement.

Conclusions:

  • Electronic monitoring (MEMS) provides a different perspective on medication adherence compared to conventional methods in pediatric ADHD.
  • Current adherence measures, including MEMS, may not fully capture the complex relationship with symptom severity and treatment outcomes in ADHD.
  • Further research is warranted to identify factors influencing medication adherence in children with ADHD.
Abstract

Keywords:
AdherenceAttention-deficit hyperactivity disorderMedication Event Monitoring SystemSymptoms

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