A worldwide increase in the use of pharmacological treatments for ADHD over the past decade has been accompanied by the emergence of many new pharmacological treatment options for patients with ADHD and new treatment guidelines. This study explored patterns and prevalence of ADHD medication use in children aged ≤16 years in the UK. Persistence, defined as the duration of time from initiation to discontinuation of therapy, was also examined in these children.
The study population consisted of 14,748 patients aged ≤16 years who received at least one prescription for an ADHD drug (methylphenidate, atomoxetine, dexamphetamine and modafinil) between 1 January 1992 and 31 December 2013, and who were registered in the Clinical Practice Research Datalink database for at least 1 year. Yearly prevalence was calculated by dividing the number of children who received at least one prescription of an ADHD medication by the mid-year counts of children aged ≤16 years registered in the database during that year. Yearly incidence of drug initiation was calculated by dividing the number of children who received their first prescription by the mid-year counts of children aged ≤16 years registered in the database during that year.
Between 1995 and 2013, the overall prevalence of children receiving ADHD drugs increased 34-fold from 1.5/10,000 children to 50.7/10,000 children in 2008, and then stabilised to 51.1/10,000 children in 2013. The increase was mostly driven by a rise in methylphenidate prescriptions, although a substantial, 5-fold increase in the use of atomoxetine was also observed between 2004 and 2008, followed by a decrease between 2008 and 2013. The overall incidence of ADHD drug use increased from 1.1 in 1995 to 10.2/10,000 in 2007 then declined to 9.1/10,000 in 2013. The proportions of persistent patients were 77% and 60% after 1 and 2 years from treatment initiation, respectively.
The findings revealed a substantial increase in the prevalence and incidence of ADHD drug use in children, with a marked increase from 1992 until 2008 followed by stabilisation. Relative to other European countries, treatment persistence remained high in the UK.
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Beau-Lejdstrom R, Douglas I, Evans SJ, et al. Latest trends in ADHD drug prescribing patterns in children in the UK: prevalence, incidence and persistence. BMJ Open 2016; 6: e010508.