A study conducted in Istanbul, Turkey aimed to investigate the factors predicting adherence with pharmacotherapy among adults with ADHD, in an attempt to identify special populations at risk of non-adherence at treatment initiation. The results indicate that non-adherence remains a significant issue among adults with ADHD and that multiple factors are associated with better adherence to treatment.
In this retrospective chart review study, participants (n=102; mean age 28.8 years) received a diagnosis of ADHD based on the Diagnostic and Statistical Manual of Mental Disorders – 4th Edition Text Revision criteria,* and were offered either atomoxetine or long-acting methylphenidate treatment combined with psychoeducation. The participants’ sociodemographic and clinical characteristics, and information on their domains of dysfunction, were collected.† Adherent patients were those who participated in both the first (within 4 weeks) and second (4–8 weeks) follow-up appointments and reported at least 80% adherence with the medication regimen prescribed. Failure to meet these conditions resulted in poor adherence.
Adherence to the treatment regimen was reported in 58.8% of patients. Patients with a university education and those with a referral based on a family history of ADHD were more likely to comply with treatment (p=0.05 and p=0.03, respectively). Non-adherence was significantly related to reasons for referral other than ADHD (p=0.02).
Factors that were unrelated to treatment adherence included diagnosis of ADHD in childhood, diagnosis of ADHD not otherwise specified, type of medication used for treatment (methylphenidate or atomoxetine), individual domains of dysfunction and use of additional psychotropic drugs.
This study was limited by its cross-sectional, retrospective design and the absence of documentation of symptoms and effects of treatment, in addition to sampling bias. Nevertheless, the results shed light on the persisting problem of non-adherence and raise awareness towards special populations at risk, which prompts the implementation of strategies that promote treatment adherence in order to mitigate the negative consequences of non-adherence (e.g. worse prognosis and higher relapse rate).
Read more about non-adherence to treatment among adults with ADHD here
*Diagnosis was supported by the Adult ADHD Self-Report Scale Turkish version
†Gender, marital status, education, vocational status, history of childhood diagnosis of ADHD, reasons for application for treatment, history of comorbid psychiatric disorders and medications used for treatment
Semerci B, Taskıran S, Tufan E, et al. Factors predicting treatment adherence in patients with adult attention-deficit/hyperactivity disorder: a preliminary study. Atten Defic Hyperact Disord 2016; 8: 139-147.