Treatment Adherence in ADHD: A Systematic Review of Influencing Factors and Strategies for Improvement

The goal of this review was to more clearly understand what encourages or discourages treatment adherence in individuals with ADHD across different points in life. Instead of simply listing barriers, we set out to identify true, evidence-based strategies that could help patients and clinicians maximize long-term dedication to care.

Following PRISMA guidelines, we systematically reviewed 52 peer-reviewed articles between 2014 and 2024. The primary sources used were five electronic databases (Scopus, Science Direct, PubMed, and Taylor & Francis). The studies included heterogeneous age groups-children, adolescents, and adults-and had diverse methodologies ranging from randomized controlled trials to qualitative interviews.

Adherence to treatment for ADHD remains a problem, especially among teenagers. We organized the influencing factors into five main areas: sociodemographic, psychological/clinical features, medication-related issues, beliefs and attitudes, and broader systemic or environmental challenges. Conversely, interventions like pharmacological strategies, digital interventions and mobile-based reminders, psychoeducational and behavioral approaches, multimodal and long-term interventions, and consent-based strategies were all linked to improved adherence.

Improving adherence in ADHD requires a multifaceted, personalized approach that considers clinical, psychological, and contextual factors. Interventions that integrate pharmacologic and psychosocial strategies, while addressing barriers such as stigma, system fragmentation, and cultural mismatch, are essential to achieving better treatment outcomes and quality of life for individuals with ADHD.