Initiation and Persistence of Pharmacotherapy for Youths with Attention Deficit Hyperactivity Disorder in Taiwan.

PLoS One 2016 12;11(8):e0161061. Epub 2016 Aug 12.

Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.

Background: Pharmacotherapy is an effective therapeutic option for attention deficit hyperactivity disorder (ADHD). Understanding the patterns of medication treatment is crucial for clinical practice. This study employed nationwide population-based data to elucidate the initiation and persistence of pharmacotherapy (immediate-release methylphenidate [IR-MPH], osmotic controlled-release formulations of methylphenidate [OROS-MPH] and atomoxetine [ATX]) for youths with ADHD in Taiwan.

Methods: Patients first receiving an ADHD diagnosis at age 18 or younger between January 2000 and December 2009 (n = 112,140; mean age at ADHD diagnosis: 7.7 years) were selected from Taiwan's National Health Insurance database. All patients were monitored through December 31, 2011, with an average follow-up time of 5.8 years. The initiation of ADHD drug therapy was defined as the first patient prescription, and discontinuation was defined as the cessation of ADHD medication for 180 days or longer.

Results: Within the first year after ADHD diagnosis, 47.3%, 14.4%, and 0.8% of the patients were prescribed IR-MPH, OROS-MPH, and ATX, respectively. Regarding the patients prescribed IR-MPH, OROS-MPH, and ATX, 17.8%, 12.6%, and 18.8%, respectively, received the prescription only once and never returned for a drug refill, and 51.0%, 38.9%, and 58.8%, respectively, discontinued drug therapy within 1 year after the first prescription. Male sex and neuropsychiatric comorbidities were associated with higher probabilities of being prescribed one of the medications. An older age at first prescription and a higher daily dose of prescription were significant predictors of early discontinuation of ADHD medication.

Conclusions: The current findings suggest that IR-MPH is the most frequently prescribed drug for ADHD treatment in Taiwan. Patients treated with OROS-MPH possessed the highest persistence rate, whereas those treated with ATX had the lowest persistence rate. The results provide insight into the delivery of pediatric mental health services and have crucial implications for ADHD medication treatment in real clinical settings.

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0161061PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4982593PMC
August 2017
10 Reads

Publication Analysis

Top Keywords

adhd diagnosis
12
adhd
10
ir-mph oros-mph
8
oros-mph atx
8
hyperactivity disorder
8
prescribed ir-mph
8
patients prescribed
8
adhd medication
8
medication treatment
8
deficit hyperactivity
8
drug therapy
8
persistence rate
8
persistence pharmacotherapy
8
attention deficit
8
initiation persistence
8
patients
5
prescription
5
insurance database
4
monitored december
4
medications older
4

References

(Supplied by CrossRef)
The worldwide prevalence of ADHD: a systematic review and metaregression analysis
G Polanczyk et al.
The American Journal of Psychiatry 2007
A 3-year panel study of mental disorders among adolescents in Taiwan
SS Gau et al.
The American Journal of Psychiatry 2005
Diagnostic and Statistical Manual of Mental Disorders
2000
The evidence-based pharmacological treatment of paediatric ADHD
BS Vaughan et al.
International Journal of Neuropsychopharmacology 2012

Similar Publications