ADHD medication discontinuation and non-adherence: a Norwegian population-based register study

Area of Science:

• Neuroscience
• Pediatrics
• Pharmacology

Background:

• Attention-deficit/hyperactivity disorder (ADHD) medication adherence is crucial for long-term care, yet patterns in adolescents are not well-understood.
• Age- and sex-specific medication adherence trajectories in pediatric ADHD populations require further characterization.

Purpose of the Study:

• To investigate medication initiation, discontinuation, and long-term adherence in children and adolescents with ADHD.
• To identify age- and sex-specific patterns in ADHD medication use within a real-world setting.

Main Methods:

• A nationwide retrospective cohort study of 8961 children and adolescents (<18 years) diagnosed with ADHD.
• Analysis of medication initiation rates, time to discontinuation, and longitudinal adherence over 9 years (2010-2021).

Main Results:

• 74.3% of individuals initiated ADHD medication, with a median delay of 106 days.
• Medication discontinuation significantly increased with age, with older adolescents (15-17 years) discontinuing earlier than younger children (5-11 years).
• Females were also found to discontinue medication earlier than males, and older age at initiation and female sex were linked to steeper declines in medication coverage over time.

Conclusions:

• ADHD medication discontinuation and low adherence are prevalent, particularly increasing through adolescence.
• Females face a higher risk of early ADHD medication cessation, highlighting the need for tailored clinical support.
• Close monitoring, shared decision-making, and sex-specific strategies are essential for managing ADHD treatment in late adolescence.