Treatment of ADHD in adults – prevalence of discontinuation and associated factors – results from a cross-sectional analysis of Danish register data

Mohr-Jensen, Christina; Lange, Anne-Mette; Thomsen, Per Hove; Daley, David

Abstract

Background: A growing number of adults are receiving pharmacological treatment for ADHD but a sizable proportion also discontinues or have gaps in treatment. The primary aims of this study were to identify how many patients treated for ADHD in adulthood, have at least one event of discontinuation in treatment and to identify possible associated variables. Methods: Within the Danish population aged 18–60 years on the 1st of January 2013, we identified the number of individuals who had been prescribed ADHD-medication at least once during the 1st of January 2002–31st of December 2013 using Danish register data. Among those who filed more than one prescription, treatment discontinuation was defined as having more than 211 days between two prescriptions. In crude and adjusted logistic regression analysis, we explored potential associations to discontinuation for variables such as gender and age at treatment initiation. Results: In a population, if N = 3,165,844 individuals, n = 42,892 had received at least one prescription for ADHD medication. Among those with more than one prescription (N = 38,289), 29.4% had discontinued their treatment at least once, according to our definition of treatment discontinuation. ADHD treatment discontinuation was associated with being male, unemployment, lower educational attainment, receiving incapacity benefits and younger age at treatment initiation (p < 0.001). Conclusions: A large proportion of individuals treated for ADHD had at least one discontinuation of treatment according to our definition. Although the present study does not allow for investigating the direction of these effects, nor whether some patients later resumed treatment, having at least one discontinuation was associated with a range of variables relating to e.g. age and gender, and provides an emerging profile for clinicians of patients more likely to discontinue.

Citation

Mohr-Jensen, C., Lange, A., Thomsen, P. H., & Daley, D. (2020). Treatment of ADHD in adults – prevalence of discontinuation and associated factors – results from a cross-sectional analysis of Danish register data. Nordic Journal of Psychiatry, 74(7), 479-488. https://doi.org/10.1080/08039488.2020.1740781

• Journal Article Type: Article
• Acceptance Date: Mar 5, 2020
• Online Publication Date: Jul 15, 2020
• Publication Date: Jul 15, 2020
• Deposit Date: Mar 9, 2020
• Publicly Available Date: Jul 16, 2021
• Journal: Nordic Journal of Psychiatry
• Print ISSN: 0803-9488
• Electronic ISSN: 1502-4725
• Peer Reviewed: Peer Reviewed
• Volume: 74
• Issue: 7
• Pages: 479-488
• DOI: https://doi.org/10.1080/08039488.2020.1740781
• Keywords: ADHD; treatment' compliance; discontinuation; stability
• Public URL: https://nottingham-repository.worktribe.com/output/4115732
• Publisher URL: https://www.tandfonline.com/doi/full/10.1080/08039488.2020.1740781
• Additional Information: This is an Accepted Manuscript of an article published by Taylor & Francis in Nordic Journal of Psychiatry on 15.07.2020, available online: http://www.tandfonline.com/10.1080/08039488.2020.1740781