OBJECTIVE: Despite a substantial increase in total methylphenidate (MPH) prescriptions in Germany over the last 20 years, and the introduction of modified release MPH (MR MPH) and atomoxetine (ATX), remarkably little is known about treatment patterns of attention- deficit/hyperactivity disorder (ADHD) in individual patients. METHODS: Usage patterns of ADHD drugs in children and adolescents in Germany were analyzed using data from one large German health insurance including >7,200,000 members. Of those, 6210 ADHD patients newly diagnosed in 2005 were followed for a maximum of 4 years. Kaplan-Meier estimates were calculated for onset and discontinuation of ADHD drug treatment. Predictors of time until drug treatment initiation were assessed by Cox regression. RESULTS: During follow-up, 52.0% of ADHD subjects (53.4% of boys, 47.5% of girls) received ADHD drug treatment. The majority of them (91.6%) were started on MPH, with immediate release MPH (IR MPH) being the initial treatment choice in 75.3%. In these subjects, change to drug treatment with MR MPH in the first year occurred in 48% by switch or addition. Significant predictors of drug treatment were behavioral and emotional disorders (HR=1.13; 95% CI 1.03-1.24) and a diagnosis of ADHD with conduct disorder (HR=1.21, 95% CI 1.12-1.32), whereas young age showed a protective effect. After 6, 12, and 24 months of treatment initiation, 22.4%, 43.4%, and 66.3% of treated girls, and 17.8%, 36.1%, and 54.1% of treated boys had discontinued ADHD treatment. CONCLUSION: Drug treatment of ADHD was relatively common in Germany and more frequent in boys than in girls. IR MPH was the predominant treatment choice at treatment initiation. Approximately 20% of treated subjects discontinued drug treatment within the first 6 months, with girls stopping drug treatment earlier than boys. The reasons for early drug discontinuation need to be further explored.
OBJECTIVE: Despite a substantial increase in total methylphenidate (MPH) prescriptions in Germany over the last 20 years, and the introduction of modified release MPH (MR MPH) and atomoxetine (ATX), remarkably little is known about treatment patterns of attention- deficit/hyperactivity disorder (ADHD) in individual patients. METHODS: Usage patterns of ADHD drugs in children and adolescents in Germany were analyzed using data from one large German health insurance including >7,200,000 members. Of those, 6210 ADHDpatients newly diagnosed in 2005 were followed for a maximum of 4 years. Kaplan-Meier estimates were calculated for onset and discontinuation of ADHD drug treatment. Predictors of time until drug treatment initiation were assessed by Cox regression. RESULTS: During follow-up, 52.0% of ADHD subjects (53.4% of boys, 47.5% of girls) received ADHD drug treatment. The majority of them (91.6%) were started on MPH, with immediate release MPH (IR MPH) being the initial treatment choice in 75.3%. In these subjects, change to drug treatment with MR MPH in the first year occurred in 48% by switch or addition. Significant predictors of drug treatment were behavioral and emotional disorders (HR=1.13; 95% CI 1.03-1.24) and a diagnosis of ADHD with conduct disorder (HR=1.21, 95% CI 1.12-1.32), whereas young age showed a protective effect. After 6, 12, and 24 months of treatment initiation, 22.4%, 43.4%, and 66.3% of treated girls, and 17.8%, 36.1%, and 54.1% of treated boys had discontinued ADHD treatment. CONCLUSION: Drug treatment of ADHD was relatively common in Germany and more frequent in boys than in girls. IR MPH was the predominant treatment choice at treatment initiation. Approximately 20% of treated subjects discontinued drug treatment within the first 6 months, with girls stopping drug treatment earlier than boys. The reasons for early drug discontinuation need to be further explored.
Authors: Mark Wolraich; Lawrence Brown; Ronald T Brown; George DuPaul; Marian Earls; Heidi M Feldman; Theodore G Ganiats; Beth Kaplanek; Bruce Meyer; James Perrin; Karen Pierce; Michael Reiff; Martin T Stein; Susanna Visser Journal: Pediatrics Date: 2011-10-16 Impact factor: 7.124
Authors: Tobias Banaschewski; David Coghill; Paramala Santosh; Alessandro Zuddas; Philip Asherson; Jan Buitelaar; Marina Danckaerts; Manfred Döpfner; Stephen V Faraone; Aribert Rothenberger; Joseph Sergeant; Hans-Christoph Steinhausen; Edmund J S Sonuga-Barke; Eric Taylor Journal: Z Kinder Jugendpsychiatr Psychother Date: 2008-03
Authors: Edmund J S Sonuga-Barke; David Coghill; Timothy Wigal; Marc DeBacker; James Swanson Journal: J Child Adolesc Psychopharmacol Date: 2009-12 Impact factor: 2.576
Authors: Jennifer E Enns; Jason R Randall; Mark Smith; Dan Chateau; Carole Taylor; Marni Brownell; James M Bolton; Elaine Burland; Alan Katz; Laurence Y Katz; Nathan C Nickel Journal: Can J Psychiatry Date: 2017-02-01 Impact factor: 4.356
Authors: Kenneth K C Man; David Coghill; Esther W Chan; Wallis C Y Lau; Chris Hollis; Elizabeth Liddle; Tobias Banaschewski; Suzanne McCarthy; Antje Neubert; Kapil Sayal; Patrick Ip; Martijn J Schuemie; Miriam C J M Sturkenboom; Edmund Sonuga-Barke; Jan Buitelaar; Sara Carucci; Alessandro Zuddas; Hanna Kovshoff; Peter Garas; Peter Nagy; Sarah K Inglis; Kerstin Konrad; Alexander Häge; Eric Rosenthal; Ian C K Wong Journal: JAMA Psychiatry Date: 2017-10-01 Impact factor: 21.596