ADHD medication discontinuation and persistence across the lifespan: a retrospective observational study using...

Area of Science:

• Pharmacology
• Psychiatry
• Public Health

Background:

• Medication discontinuation for attention-deficit/hyperactivity disorder (ADHD) is a frequent occurrence, despite the long-term nature of treatment.
• Cross-national data on ADHD medication discontinuation rates are lacking due to the absence of standardized measurement tools.

Purpose of the Study:

• To determine the rate of ADHD medication treatment discontinuation across different age groups throughout the lifespan.
• To compare discontinuation patterns internationally to inform clinical practice.

Main Methods:

• A retrospective, observational study utilizing population-based prescription data from nine global regions (Australia, Denmark, Hong Kong, Iceland, the Netherlands, Norway, Sweden, the UK, and the USA).
• Analysis of new users of ADHD medication aged 3 years and older, initiating treatment between 2010 and 2020.
• Estimation of treatment discontinuation and persistence over 5 years post-initiation, stratified by age (children, adolescents, young adults, adults) and sex.

Main Results:

• Over 1.2 million individuals were included in the study.
• Treatment discontinuation was lowest in children and highest in young adults and adolescents.
• Within one year, treatment retention was 65% for children, 47% for adolescents, 39% for young adults, and 48% for adults. Discontinuation peaked between ages 18-19.
• Treatment persistence up to 5 years was higher when accounting for medication reinitiation, with 50-60% of children and 30-40% of adolescents and adults covered in most countries.

Conclusions:

• Early discontinuation of ADHD medication is prevalent, particularly among young adults.
• Treatment persistence in adolescents and young adults is lower than anticipated, even with reinitiation.
• Findings provide crucial insights into long-term ADHD medication use patterns across the lifespan.