Joseph Biederman1,2, Ronna Fried3,4, Maura DiSalvo3, K Yvonne Woodworth3, Itai Biederman3, Haley Driscoll3, Elizabeth Noyes3, Stephen V Faraone5,6, Roy H Perlis3,4,7. 1. Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, 55 Fruit Street, YAW 6900, Boston, MA, 02114, USA. jbiederman@partners.org. 2. Department of Psychiatry, Harvard Medical School, Boston, MA, USA. jbiederman@partners.org. 3. Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, 55 Fruit Street, YAW 6900, Boston, MA, 02114, USA. 4. Department of Psychiatry, Harvard Medical School, Boston, MA, USA. 5. Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA. 6. K.G. Jebsen Centre for Psychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway. 7. Center for Quantitative Health, Massachusetts General Hospital, Boston, MA, USA.
Abstract
RATIONALE: ADHD is a prevalent and morbid neurobiological disorder affecting up to 5% of adults. While stimulants have been documented to be safe and effective in adults with ADHD, uncertainties remain about adherence to these treatments. OBJECTIVES: The main aim of this article was to evaluate contemporaneous rates and correlates of adherence to stimulants in adults with ADHD using data from electronic medical records from a large healthcare organization focusing on timely renewal of an initial prescription. METHODS: Subjects were patients 18 to 44 years of age who had been prescribed a stimulant between January 1, 2015, and December 31, 2016. Prescription and sociodemographic data were extracted from the Partners HealthCare Research Patient Data Registry (RPDR). Our outcome metric was renewal of the index stimulant prescription defined as the first prescription recorded in the electronic record for the period under investigation. RESULTS: We identified 2689 patients with an index prescription for a stimulant medication. Results showed that only 42% of patients renewed their prescriptions in a timely enough fashion to be considered consistently medicated. CONCLUSIONS: Results indicate that adults with ADHD have a low rate of renewal of their initial stimulant prescription indicating poor patient engagement in their treatment for ADHD.
RATIONALE: ADHD is a prevalent and morbid neurobiological disorder affecting up to 5% of adults. While stimulants have been documented to be safe and effective in adults with ADHD, uncertainties remain about adherence to these treatments. OBJECTIVES: The main aim of this article was to evaluate contemporaneous rates and correlates of adherence to stimulants in adults with ADHD using data from electronic medical records from a large healthcare organization focusing on timely renewal of an initial prescription. METHODS: Subjects were patients 18 to 44 years of age who had been prescribed a stimulant between January 1, 2015, and December 31, 2016. Prescription and sociodemographic data were extracted from the Partners HealthCare Research Patient Data Registry (RPDR). Our outcome metric was renewal of the index stimulant prescription defined as the first prescription recorded in the electronic record for the period under investigation. RESULTS: We identified 2689 patients with an index prescription for a stimulant medication. Results showed that only 42% of patients renewed their prescriptions in a timely enough fashion to be considered consistently medicated. CONCLUSIONS: Results indicate that adults with ADHD have a low rate of renewal of their initial stimulant prescription indicating poor patient engagement in their treatment for ADHD.
Authors: David J Cote; John L Kilgallon; Noah L A Nawabi; Hassan Y Dawood; Timothy R Smith; Ursula B Kaiser; Edward R Laws; JoAnn E Manson; Meir J Stampfer Journal: J Clin Endocrinol Metab Date: 2022-03-24 Impact factor: 5.958