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Adherence to ADHD therapy high, certain factors affect compliance, study finds

Monday, October 13 2008 | Comments

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What's This? By Patrice LaVigne

Compliance with stimulant therapy for attention-deficit/hyperactivity disorder (ADHD) appears to be high, although increased efforts are needed to educate parents and patients on the importance of drug adherence, according to Dr. Sunshine Smoot from the Department of Pediatrics at  Marshall University in Huntington, West Virginia.

Dr. Smoot and colleagues evaluated the rates of adherence, risk factors linked with nonadherence, and the rationale for discontinuation among families in the current analysis. The study subjects included 182 patients who received a new diagnosis of ADHD from the same physician at Marshall University from Jan. 1 through Dec. 31, 2006, according to a review of their medical charts. Of these patients, 163 began taking stimulant drugs for their condition. Data on the number of prescription refills, office visits, telephone contacts, and adjustments to therapy were obtained through November 2007.

Overall, 56 patients (34%) discontinued treatment, and 107 patients (66%) remained compliant throughout the study period. Of those who discontinued, 36 patients (64%) did so during the first 3 months, according to Dr. Smoot.

The adherent group recorded a higher number of office visits (P<.001), more telephone contacts (P<.007), and a greater number of adjustments to their medications (P<.001). Other factors, such as the patient's sex, ADHD subtype, and rate of oppositional defiant disorder were not significantly different between the groups, all with a P value of >.05, Dr. Smoot noted.

The research team contacted 23 families who were noncompliant for an additional telephone survey. They found that 12 of the families had, in fact, continued therapy but had refilled the treatment through their primary care physician. Among the others, 6 said they discontinued because of side effects, most often being weight loss, and 5 discontinued because the parents said they were uncertain about the need for the treatment.

"A lot of it [nonadherence] is perception [among parents]," Dr. Smoot said.

"[I]ncreased efforts to educate both the parents and patients on potential adverse events and accuracy of diagnosis--particularly if the information is given during the first 3 months of treatment--may improve adherence to stimulant therapy," she added. (Abstract 487.)

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