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Using Brain Activation nir-HEG/Q-EEG and Execution Measures CPTs in a ADHD Assessment Protocol
Published on: April 1, 2018
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Treatment patterns among adults with ADHD receiving long-acting therapy
Zhou Zhou1, Zheng-Yi Zhou, Sneha S Kellar
1Analysis Group, Inc, 111 Huntington Ave, Fl 14, Boston, MA 02199.
The American Journal of Managed Care
|July 19, 2018
Summary
Long-acting (LA) combination therapy for attention-deficit/hyperactivity disorder (ADHD) in adults showed lower adherence and persistence compared to monotherapy. This study highlights potential challenges in ADHD treatment adherence for combination therapy patients.
Area of Science:
- Pharmacology
- Clinical Pharmacy
- Neuroscience
Background:
- Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder impacting adults.
- Long-acting (LA) medications are a cornerstone of ADHD management.
- Treatment strategies include monotherapy and combination therapy (CT).
Purpose of the Study:
- To compare treatment patterns, adherence, and persistence between LA combination therapy and LA monotherapy in US adults with ADHD.
- To identify differences in medication adherence and persistence based on treatment modality.
Main Methods:
- Retrospective analysis of a large claims database (MarketScan) from April 2009 to March 2014.
- Identification of adult patients with ADHD receiving LA medications, categorizing them into CT or monotherapy based on medication overlap.
- Adherence measured by Proportion of Days Covered (PDC ≥ 0.8) and persistence by Time to Discontinuation (TTD ≥ 30-day gap) within one year post-initiation.
Main Results:
- Out of 225,600 patients, 7.3% received LA CT and 92.7% received LA monotherapy.
- LA CT was associated with significantly lower adherence (7% vs 16%; adjusted OR, 0.38; P < .001) and persistence (median TTD 59 vs 79 days; adjusted HR, 1.32; P < .001) compared to LA monotherapy.
- Mean PDC was lower for CT (0.33) versus monotherapy (0.41).
Conclusions:
- In US adults with ADHD treated with LA medications, LA combination therapy demonstrated significantly lower adherence and persistence than LA monotherapy.
- These findings suggest potential challenges in maintaining consistent treatment with LA combination therapy for ADHD.
- Further research may explore reasons for reduced adherence and persistence in ADHD combination therapy regimens.
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