Predictors of Stimulant Medication Continuity in Children with Attention-Deficit/Hyperactivity Disorder
Kelly I Kamimura-Nishimura1,2, William B Brinkman1,3, Jeffery N Epstein1,4
1Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH.
Journal of Developmental and Behavioral Pediatrics : JDBP
|March 22, 2022
Summary
Parental beliefs and child demographics significantly impact attention-deficit/hyperactivity disorder (ADHD) medication continuity. A strong clinician-family alliance is crucial for consistent ADHD treatment adherence.
Area of Science:
- Pediatric pharmacology
- Child psychiatry
- Health services research
Background:
- Attention-deficit/hyperactivity disorder (ADHD) medication continuity is vital for effective symptom management in children.
- Factors influencing treatment adherence in pediatric ADHD populations require further investigation.
Purpose of the Study:
- To investigate patient-related, parent-related, medication-related, and healthcare system factors affecting ADHD medication continuity.
- To identify predictors of initiating and maintaining ADHD medication after a methylphenidate trial.
Main Methods:
- A cohort of 144 stimulant-naïve children with ADHD was followed for one year post-methylphenidate (MPH) trial.
- Multivariable analyses examined predictors of filled ADHD prescriptions and medication days covered.
- Factors included child demographics, symptom severity, parent mental health, parent beliefs, and therapeutic alliance.
Main Results:
- 84% of children filled at least one ADHD prescription, with an average of 178 days covered.
- A weaker clinician-family alliance predicted no filled prescriptions.
- Factors associated with fewer medication days included non-White race, older age, female sex, lower income, and negative medication beliefs; oppositional defiant disorder and parental ADHD predicted more days covered.
Conclusions:
- Child demographic factors, parental beliefs about ADHD and its treatment, and medication-related factors are associated with ADHD medication continuation.
- Findings can inform strategies to enhance ADHD medication adherence in diverse pediatric populations.
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