Journal of the Korean Academy of Child and Adolescent Psychiatry

Korean Academy of Child and Adolescent Psychiatry (대한소아청소년정신의학회)
권호 표지
DOI QR코드

DOI QR Code

Factors Affecting Adherence to Pharmacotherapy in Children with Attention-Deficit Hyperactivity Disorder: A Retrospective Study

주의력결핍 과잉행동장애 아동의 약물치료 순응도에 영향을 미치는 요인 : 후향적 연구

  • Kim, Yoon-Jung (Department of Neuropsychiatry, Eulji General Hospital) ;
  • Oh, So-Young (Department of Neuropsychiatry, Kyung Hee University School of Medicine) ;
  • Lee, Ji-Ah (Department of Neuropsychiatry, Kyung Hee University School of Medicine) ;
  • Moon, Su-Jin (Department of Neuropsychiatry, Kyung Hee University School of Medicine) ;
  • Lee, Won-Hae (Department of Neuropsychiatry, Kyung Hee University School of Medicine) ;
  • Bahn, Geon-Ho (Department of Neuropsychiatry, Kyung Hee University School of Medicine)
  • 김윤정 (을지병원 정신과) ;
  • 오소영 (경희대학교 의학전문대학원 정신과학교실) ;
  • 이지아 (경희대학교 의학전문대학원 정신과학교실) ;
  • 문수진 (경희대학교 의학전문대학원 정신과학교실) ;
  • 이원혜 (경희대학교 의학전문대학원 정신과학교실) ;
  • 반건호 (경희대학교 의학전문대학원 정신과학교실)
  • Received : 2010.10.02
  • Accepted : 2010.10.06
  • Published : 2010.10.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: To identify the factors affecting long-term adherence to methylphenidate treatment in children with attention-deficit hyperactivity disorder (ADHD). Methods: A retrospective medical record review of 239 ADHD patients (mean age $9.3{\pm}2.6$ years, range 6.0-17.4 years) who had visited the child and adolescent psychiatry clinic at a university hospital, in Seoul, Korea from March 2005 to February 2008. Subjects were diagnosed as ADHD based on the criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders 4th edition, text revision version (DSM-IV-TR) and underwent neuropsychological tests including the continuous performance test (CPT). Treatment discontinuation was defined as the last prescription date when the medication possession rate (MPR) became less than 0.80. Subjects were divided into three groups and labeled as Group I, non-adherence without pharmacotherapy, Group II, non-adherence with short-term pharmacotherapy, and Group III, adherence with long-term pharmacotherapy. Results: Ninety (37.7%) patients were grouped as non-adherent (Groups I+II) and 149 (62.3%) as adherent (Group III). The adherence group exhibited lower intelligence, higher symptom severity, and a higher number of comorbid psychiatric disorders than controls. The use of stimulants was significantly associated with long-term adherence to treatment. Additionally, the duration of interval between the date of the first visit and the date of the first prescription was positively associated with long-term adherence. Conclusion: About two-thirds of patients diagnosed as ADHD adhered to the treatment six months after the first visit. With respect to patient evaluation and the development of treatment strategies, factors affecting early drop-out and longer follow-up must be considered.

Keywords

References

  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Text Revision. Washington DC: American Psychiatric Association;2000.
  2. Polanczyk G, de Lima MS, Horta BL, Biederman J, Rohde LA. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J psychiatry 2007;164:942-948. https://doi.org/10.1176/appi.ajp.164.6.942
  3. Dopheide JA. The role of pharmacotherapy and managed care pharmacy interventions in the treatment of ADHD. Am J Manag Care 2009;15(5 Suppl):141-150.
  4. Spetie L, Arnold EL. Attention-deficit hyperactivity disorder. In: Martin A, Volkmar FR, editors. Lewis's child and adolescent psychiatry: a comprehensive textbook. 4th edition. Philadelphia: Lippincott Williams & Wilkins;2007. p.430-454.
  5. Minkoff NB. ADHD in managed care: an assessement of the burden of illness and proposed initiatives to improve outcomes. Am J Manag Care 2009;15(5 Suppl):151-159.
  6. Klassen AF, Miller A, Fine S. Health-related quality of life in children and adolescents who have a diagnosis of ADHD. Pediatrics 2004;114:e541-e547. https://doi.org/10.1542/peds.2004-0844
  7. Jensen PS, Arnold LE, Swanson JM, Vitiello B, Abikoff HB, Greenhill LL, et al. 3-year follow-up of the NIMH MTA study. J Am Acad Child Adolesc Psychiatry 2007;46:989-1002. https://doi.org/10.1097/CHI.0b013e3180686d48
  8. Molina BS, Hinshaw SP, Swanson JM, Arnold LE, Vitiello B, Jensen PS, et al. The MTA at 8 years: prospective follow-up of children treated for combined-type ADHD in a multisite study. J Am Acad Child Adolesc Psychiatry 2009;48:484-500. https://doi.org/10.1097/CHI.0b013e31819c23d0
  9. Brinkman WB, Sherman SN, Zmitrovich AR, Visscher MO, Crosby LE, Phelan KJ, et al. Parental angst making and revisiting decisions about treatment of attention-deficit hyperactivity disorder. Pediatrics 2009;124:580-589. https://doi.org/10.1542/peds.2008-2569
  10. Marcus SC, Wan GJ, Kemner JE, Olfson M. Continuity of methylphenidate treatment for ADHD. Arch Pediatr Adolesc Med 2005;159:572-578. https://doi.org/10.1001/archpedi.159.6.572
  11. The MTA Cooperative Group. A 14-month randomized clinical trial of treatment strategies for ADHD. Multimodal treatment study of children with ADHD. Arch Gen Psychiatry 1999;56:1073-1086. https://doi.org/10.1001/archpsyc.56.12.1073
  12. Cox ER, Motheral BR, Henderson RR, Mager D. Geographic variation in the prevanlence of stimulant medication use among children 5 to 14 years old: results from a commercially insured US sample. Pediatrics 2003;111:237-243. https://doi.org/10.1542/peds.111.2.237
  13. Okano GJ, Rascati KL, Wilson JP, Remund DD, Grabenstein JD, Brixner DI. Patterns of antihypertensive use among patients in the US department of defense database initially prescribed an angiotensin-converting enzyme inhibitor or calcium channel blocker. Clin Ther 1997;19:1433-1445. https://doi.org/10.1016/S0149-2918(97)80017-3
  14. Kim NS, Kim KH, Lee SM, Paik JW, Lee BR, Hwang JH. The utilization study of mental health service among depressed patients. Health Insurance Review and Assessment Service: K-47-2008-55;2008. p.31-45.
  15. Pliszka SR, Greenhill LL, Crismon ML, Sedillo A, Carlson C, Conners CK, et al. The Texas children's medication algorithm project: report of the Texas consensus conference panel on medication treatment of childhood ADHD. Part I. Attention-Deficit Hyperactivity Disorder. J Am Acad Child Adolesc Psychiatry 2000; 39:908-919. https://doi.org/10.1097/00004583-200007000-00021
  16. Shin MS, Ryu ME, Kim BN, Hwang JW, Cho SC. Development of the Korean version of the IOWA Conners rating scale. Kor J Neuropsychiatr Assoc 2005;44:82-88.
  17. Kim JH, Cho SM, Hong CH, Hwang ST. Korean personality rating scale for children, Seoul: Korean Guidance;2005.
  18. Conners K. Conners' Continuous Performance Test (CPT II) computer programs for Windows TM technical guide and software manual. New York: Multi-Health Systems Inc;1998.
  19. Kwack KJ, Park HW, Kim CT. Korean-Wechsler intelligence scale for children, 3rd ed. Seoul: Special Education Publishing Co;1991.
  20. Jadad AR, Booker L, Gauld M, Wilens TE, Macpherson HA, Faraone SV. The treatment of attention-deficit hyperactivity disorder: an annotated bibliography and critical appraisal of published systematic reviews and metaan-alyses. Can J Psychiatry 1999;44:1025-1035. https://doi.org/10.1177/070674379904401009
  21. Biederman J, Monuteaux MC, Spencer T. Stimulant therapy and risk for subsequent substance use disorders in male adults with ADHD: a naturalistic controlled 10-year follow-up study. Am J Psychiatry 2008;165:597-603. https://doi.org/10.1176/appi.ajp.2007.07091486
  22. Charach A, Ickowicz A, Schachar R. Stimulant treatment over five years: adherence, effectiveness, and adverse effects. J Am Acad Child Adolesc Psychiatry 2004;43:559-567. https://doi.org/10.1097/00004583-200405000-00009
  23. Gau SS, Chen SJ, Chou WJ, Cheng H, Tang CS, Chang HL. National survey of adherence, efficacy, and side effects of methylphenidate in children with attention-deficit/hyperactivity disorder in Taiwan. J Clin Psychiatry 2008;69:131-140. https://doi.org/10.4088/JCP.v69n0118
  24. Hwang JW, Kim BN, Cho SC. Compliance study of methylphenidate IR in the treatment of ADHD. J Kor Acad Child Adolesc Psychiatry 2004;15:160-167.
  25. Rieppi R, Greenhill LL, Ford RE, Chuang S, Mu M, Davies M, et al. Socioeconomic status as a moderator of ADHD treatment outcomes. J Am Acad Child Adolesc Psychiatry 2002;41: 269-277. https://doi.org/10.1097/00004583-200203000-00006
  26. Kim BS, Park EJ. An observational Multi-Center Study for evaluation of effecacy, safty and parental satisfaction of methylphenidate- OROS in children with ADHD. J Kor Acad Child Adolesc Psychiatry 2005;16:279-285.
  27. Gadow KD, Nolan EE, Severd J, Sprafkin J, Schwartz J. An anxiety and depression symptoms and response to methylphenidate in children with ADHD and tic disorder. J Clin Psychopharmacol 2002;22:267-274. https://doi.org/10.1097/00004714-200206000-00007
  28. Lee JB, Sung HM, Cheung SD, Kim JS, Seo WS, Dai DS, et al. The predictive factors of treatment effects in children with attention- deficit hyperactivity disorder. Kor J Psychopharmacol 2002;13:170-193.
  29. Thiruchelvam D, Charach A, Schachar R. Moderators and mediators of long-term adherence to stimulant treatment in children with ADHD. J Am Acad Child Adolesc Psychiatry 2001;40:922-928. https://doi.org/10.1097/00004583-200108000-00014

Cited by

  1. Treatment Adherence of Osmotic-Controlled Release Oral Delivery System Methylphenidate in Korean Children and Adolescents with Attention-Deficit Hyperactivity Disorder vol.25, pp.2, 2014, https://doi.org/10.5765/jkacap.2014.25.2.65
  2. Naturalistic Pharmacotherapy Compliance among Pediatric Patients with Attention Deficit/Hyperactivity Disorder: a Study Based on Three-Year Nationwide Data vol.31, pp.4, 2016, https://doi.org/10.3346/jkms.2016.31.4.611
  3. A 36 Month Naturalistic Retrospective Study of Clinic-Treated Youth with Attention-Deficit/Hyperactivity Disorder vol.24, pp.6, 2014, https://doi.org/10.1089/cap.2013.0090
  4. Comparison of Adults with Attention-Deficit Hyperactivity Disorder Depending on the Age of Being Diagnosed in Childhood and Adulthood: Based on Retrospective Review in One University Hospital vol.28, pp.3, 2017, https://doi.org/10.5765/jkacap.2017.28.3.183