Korean Journal of Clinical Pharmacy (한국임상약학회지)

Korean College Of Clinical Pharmacy (한국임상약학회)
권호 표지
DOI QR코드

DOI QR Code

Patterns and Persistence of Pharmacotherapy for Children and Adolescents with Attention Deficit Hyperactivity Disorder in South Korea

국내 주의력결핍 과잉행동 장애 아동 및 청소년의 약물요법 패턴 및 지속성

  • Received : 2018.06.12
  • Accepted : 2018.07.24
  • Published : 2018.09.03
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: This study aimed to assess treatment persistence in Korean children and adolescents with attention deficit hyperactivity disorder (ADHD) and the factors influencing their adherence to ADHD pharmacotherapy. Methods: The study included patients between 6 and 18 years of age with ADHD who were taking various formulations of methylphenidate and atomoxetine on June 1, 2014. Patients were dichotomized as "persistent" or "non-persistent", depending on whether they continued ADHD therapy for 6 months (therapy persistence). We also investigated if the patients were taking the same medication(s) as before and also classified the patients as "medication persistent" or "non-persistent". Patient' characteristics were correlated with therapy persistence and medication persistence. Multiple logistic regression analyses were performed to assess potential risk factors for treatment persistence. Results: Overall, 3,317 patients were included in the analysis. A majority of patients were taking stimulants (82.0%), 16.2% were taking non-stimulants and 1.8% were taking a combination therapy of stimulants and non-stimulants. After 6 months, 2,290 patients (69.0%) continued to take medication for ADHD with 1,953 patients taking the same medication(s) as 6 months previously. Common positive factors for therapy persistence and medication persistence were identified as younger age, retardation, and developmental delay, and long-acting formulations of methylphenidate as either monotherapy or in a combination therapy may be used. Conclusion: ADHD medications were proven to improve academic performance and social skills of children. Collaboration between patients, parents, school staffs, and prescribers is required to improve the persistent use of ADHD medications.

Keywords

References

  1. Association AP. Diagnostic and statistical manual of mental disorders ($DSM-5^{(R)}$): American Psychiatric Pub; 2013. Available from https://www.psychiatry.org/psychiatrists/practice/dsm. Accessed July 3, 2018.
  2. Subcommittee on Attention-Deficit/Hyperactivity D, Steering Committee on Quality I, Management, et al. ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/ hyperactivity disorder in children and adolescents. Pediatrics 2011;128:1007-22. https://doi.org/10.1542/peds.2011-2654
  3. Polanczyk G, de Lima MS, Horta BL, et al. The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry 2007;164:942-8. https://doi.org/10.1176/ajp.2007.164.6.942
  4. Polanczyk GV, Willcutt EG, Salum GA, et al. ADHD prevalence estimates across three decades: an updated systematic review and metaregression analysis. Int J Epidemiol 2014;43:434-42. https://doi.org/10.1093/ije/dyt261
  5. Willcutt EG. The prevalence of DSM-IV attention-deficit/hyperactivity disorder: a meta-analytic review. Neurotherapeutics 2012;9:490-9. https://doi.org/10.1007/s13311-012-0135-8
  6. Faraone SV, Sergeant J, Gillberg C, et al. The worldwide prevalence of ADHD: is it an American condition? World Psychiatry 2003;2:104-13.
  7. Yang SJ, Cheong S, Hong SD. Prevalence and correlates of attention deficit hyperactivity disorder: school-based mental health services in Seoul. J Korean Neuropsychiatr Assoc 2006;45:69-76.
  8. Cho S-C, Shin Y-O. Prevalence of disruptive behavior disorders. J Korean Acad Child Adolesc Psychiatry 1994;5:141-9.
  9. Kim JY, Ahn DH, Shin YJ. An epidemiological study of attention-deficits hyperactivity disorder and learning disabilities in a rural area. J Korean Neuropsychiatr Assoc 1999;38:784-93.
  10. Center SCaAMH. Reports of epidemiological study. 2005.
  11. Huh Y, Choi I, Song M, et al. A comparison of comorbidity and psychological outcomes in children and adolescents with attention-deficit/hyperactivity disorder. Psychiatry Investig 2011;8:95-101. https://doi.org/10.4306/pi.2011.8.2.95
  12. Ambrosini PJ, Bennett DS, Elia J. Attention deficit hyperactivity disorder characteristics: II. Clinical correlates of irritable mood. J Affect Disord 2013;145:70-6. https://doi.org/10.1016/j.jad.2012.07.014
  13. Bussing R, Mason DM, Bell L, et al. Adolescent outcomes of childhood attention-deficit/hyperactivity disorder in a diverse community sample. J Am Acad Child Adolesc Psychiatry 2010;49:595-605.
  14. Jensen PS, Hinshaw SP, Swanson JM, et al. Findings from the NIMH Multimodal Treatment Study of ADHD (MTA): implications and applications for primary care providers. J Dev Behav Pediatr 2001;22:60-73. https://doi.org/10.1097/00004703-200102000-00008
  15. Larson K, Russ SA, Kahn RS, et al. Patterns of comorbidity, functioning, and service use for US children with ADHD, 2007. Pediatrics 2011;127:462-70. https://doi.org/10.1542/peds.2010-0165
  16. Group MC. A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. Arch Gen Psychiatry 1999;56:1073-86. https://doi.org/10.1001/archpsyc.56.12.1073
  17. Pliszka SR. Comorbidity of attention-deficit/hyperactivity disorder with psychiatric disorder: an overview. J Clin Psychiatry 1998;59:50-8.
  18. Biederman J, Spencer T, Wilens T. Evidence-based pharmacotherapy for attention-deficit hyperactivity disorder. Int J Neuropsychopharmacol 2004;7:77-97. https://doi.org/10.1017/S1461145703003973
  19. Briars L, Todd T. A Review of Pharmacological Management of Attention-Deficit/Hyperactivity Disorder. J Pediatr Pharmacol Ther 2016;21:192-206.
  20. Spencer T, Biederman J, Wilens T, et al. Pharmacotherapy of attention-deficit hyperactivity disorder across the life cycle. J Am Acad Child Adolesc Psychiatry 1996;35:409-32. https://doi.org/10.1097/00004583-199604000-00008
  21. Meijer WM, Faber A, van den Ban E, et al. Current issues around the pharmacotherapy of ADHD in children and adults. Pharm World Sci 2009;31:509-16. https://doi.org/10.1007/s11096-009-9302-3
  22. Gajria K, Lu M, Sikirica V, et al. Adherence, persistence, and medication discontinuation in patients with attention-deficit/hyperactivity disorder - a systematic literature review. Neuropsychiatr Dis Treat 2014;10:1543-69.
  23. Lara C, Fayyad J, de Graaf R, et al. Childhood predictors of adult ADHD: results from the WHO World Mental Health (WMH) Survey Initiative. Biol Psychiatry 2009;65:46-54. https://doi.org/10.1016/j.biopsych.2008.10.005
  24. McCarthy S, Asherson P, Coghill D, et al. Attention-deficit hyperactivity disorder: treatment discontinuation in adolescents and young adults. Br J Psychiatry 2009;194:273-7. https://doi.org/10.1192/bjp.bp.107.045245
  25. McCarthy S, Wilton L, Murray ML, et al. Persistence of pharmacological treatment into adulthood, in UK primary care, for ADHD patients who started treatment in childhood or adolescence. BMC Psychiatry 2012;12:219. https://doi.org/10.1186/1471-244X-12-219
  26. Kim L, Kim J-A, Kim S. A guide for the utilization of Health Insurance Review and Assessment Service National Patient Samples. Epidemiol Health 2014;36:e2014008.
  27. Ahmed R, Aslani P. Attention-deficit/hyperactivity disorder: an update on medication adherence and persistence in children, adolescents and adults. Expert Rev Pharmacoecon Outcomes Res 2013;13:791-815. https://doi.org/10.1586/14737167.2013.841544
  28. Wang LJ, Yang KC, Lee SY, et al. Initiation and Persistence of Pharmacotherapy for Youths with Attention Deficit Hyperactivity Disorder in Taiwan. PLoS One 2016;11:e0161061. https://doi.org/10.1371/journal.pone.0161061
  29. Ho PM, Bryson CL, Rumsfeld JS. Medication Adherence. Its Importance in Cardiovascular Outcomes. Circulation 2009;119:3028-35. https://doi.org/10.1161/CIRCULATIONAHA.108.768986
  30. Halpern MT, Khan ZM, Schmier JK, et al. Recommendations for Evaluating Compliance and Persistence With Hypertension Therapy Using Retrospective Data. Hypertension 2006;47:1039-48. https://doi.org/10.1161/01.HYP.0000222373.59104.3d
  31. Ayaz M, Ayaz AB, Soylu N, et al. Medication Persistence in Turkish Children and Adolescents with Attention-Deficit/Hyperactivity Disorder. J Child Adolesc Psychopharmacol 2014;24:442-7. https://doi.org/10.1089/cap.2014.0002
  32. Winterstein AG, Gerhard T, Shuster J, et al. Utilization of pharmacologic treatment in youths with attention deficit/hyperactivity disorder in Medicaid database. Ann Pharmacother 2008;42:24-31. https://doi.org/10.1345/aph.1K143
  33. Garbe E, Mikolajczyk RT, Banaschewski T, et al. Drug treatment patterns of attention-deficit/hyperactivity disorder in children and adolescents in Germany: results from a large population-based cohort study. J Child Adolesc Psychopharmacol 2012;22:452-8. https://doi.org/10.1089/cap.2012.0022
  34. McCarthy S, Wilton L, Murray ML, et al. Persistence of pharmacological treatment into adulthood, in UK primary care, for ADHD patients who started treatment in childhood or adolescence. BMC psychiatry 2012;12:1. https://doi.org/10.1186/1471-244X-12-1
  35. Atzori P, Usala T, Carucci S, et al. Predictive factors for persistent use and compliance of immediate-release methylphenidate: a 36-month naturalistic study. J Child Adolesc Psychopharmacol 2009;19:673-81. https://doi.org/10.1089/cap.2008.0146
  36. Park J, Kim B. Comorbidity and Factors Affecting Treatment Non-Persistence in ADHD. J Atten Disord 2015.
  37. Miller VA, Drotar D. Decision-making competence and adherence to treatment in adolescents with diabetes. J Pediatr Psychol 2007;32:178- 88.
  38. Chacko A, H Newcorn J, Feirsen N, et al. Improving medication adherence in chronic pediatric health conditions: a focus on ADHD in youth. Curr Pharm Des 2010;16:2416-23. https://doi.org/10.2174/138161210791959908
  39. van den Ban E, Souverein PC, Swaab H, et al. Less discontinuation of ADHD drug use since the availability of long-acting ADHD medication in children, adolescents and adults under the age of 45 years in the Netherlands. Atten Defic Hyperact Disord 2010;2:213-20. https://doi.org/10.1007/s12402-010-0044-9
  40. Atzori P, Usala T, Carucci S, et al. Predictive factors for persistent use and compliance of immediate-release methylphenidate: a 36-month naturalistic study. J Child Adolesc Psychopharmacol 2009;19:673-81. https://doi.org/10.1089/cap.2008.0146
  41. Baucom KJ, Queen TL, Wiebe DJ, et al. Depressive symptoms, daily stress, and adherence in late adolescents with type 1 diabetes. Health Psychol 2015;34:522. https://doi.org/10.1037/hea0000219
  42. DiMatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med 2000;160:2101-7. https://doi.org/10.1001/archinte.160.14.2101
  43. Wing RR, Phelan S, Tate D. The role of adherence in mediating the relationship between depression and health outcomes. J Psychosom Res 2002;53:877-81. https://doi.org/10.1016/S0022-3999(02)00315-X
  44. Raman SR, Marshall SW, Gaynes BN, Haynes K, Naftel AJ, Sturmer T. An observational study of pharmacological treatment in primary care of children with ADHD in the United Kingdom. Psychiatr Serv 2015;66:617-24. https://doi.org/10.1176/appi.ps.201300148
  45. Lawson KA, Johnsrud M, Hodgkins P, et al. Utilization patterns of stimulants in ADHD in the Medicaid population: a retrospective analysis of data from the Texas Medicaid program. Clin Ther 2012;34:944-956. https://doi.org/10.1016/j.clinthera.2012.02.021
  46. Bhang S-Y, Hwang J-W, Kwak Y-S, et al. Differences in Utilization Patterns among Medications in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder: a 36-Month Retrospective Study Using the Korean Health Insurance Review and Assessment Claims Database. J Korean Med Sci 2016;31:1284-91. https://doi.org/10.3346/jkms.2016.31.8.1284
  47. Gau SS-F, Shen H-Y, Soong W-T, et al. An open-label, randomized, active-controlled equivalent trial of osmotic release oral system methylphenidate in children with attention-deficit/hyperactivity disorder in Taiwan. J Child Adolesc Psychopharmacol 2006;16:441-55. https://doi.org/10.1089/cap.2006.16.441
  48. Steele M, Weiss M, Swanson J, et al. A randomized, controlled effectiveness trial of OROS-methylphenidate compared to usual care with immediate-release methylphenidate in attention deficit-hyperactivity disorder. Can J Clin Pharmacol 2006;13:e50-e62.
  49. Charach A, Fernandez R. Enhancing ADHD medication adherence: challenges and opportunities. Curr Psychiatry Rep 2013;15:371. https://doi.org/10.1007/s11920-013-0371-6
  50. Rezaei G, Hosseini SA, Akbari Sari A, et al. Comparative efficacy of methylphenidate and atomoxetine in the treatment of attention deficit hyperactivity disorder in children and adolescents: A systematic review and meta-analysis. Med J Islam Repub Iran 2016;30:325.
  51. Lawson KA, Johnsrud M, Hodgkins P, et al. Utilization patterns of stimulants in ADHD in the Medicaid population: a retrospective analy- sis of data from the Texas Medicaid program. Clin Ther 2012;34:944-56. https://doi.org/10.1016/j.clinthera.2012.02.021
  52. Gajria K, Lu M, Sikirica V, et al. Adherence, persistence, and medication discontinuation in patients with attention-deficit/hyperactivity disorder-a systematic literature review. Neuropsychiatr Dis Treat 2014;10:1543-69.