Predictors and consequences of adherence to the treatment of pediatric patients with attention-deficit/hyperactivity disorder in Central Europe and East Asia

Figures & data

Table 1 Baseline patient characteristics by adherence status during follow-up

Baseline characteristic	Non-adherent during follow-up (n = 305)	Adherent during follow-up (n = 555)
Age, mean (SD)	9.29 (2.67)	8.98 (2.48)
Male	83.83%	80.37%
Age at first symptoms, mean (SD)	5.51 (2.32)	5.45 (2.41)
Being from East Asia (versus Central Europe)*	54.75%	37.48%
BMI (kg/m^2), mean (SD)*	18.71 (3.79)	18.13 (3.62)
Birth problems	28.81%	28.22%
Family history of ADHD	48.79%	48.36%
Having other children living at home*	48.45%	63.41%
CGI-ADHD, mean (SD)	4.58 (0.96)	4.50 (1.00)
CSI-4 category A (standardized), mean (SD)	76.10 (10.57)	76.50 (10.65)
Paid employment (mother)	72.91%	68.27%
Paid employment (father)	90.97%	87.27%
Parental emotional distress due to their children’s behavioral problems*	57.97%	45.16%
Being truant in the past 4 weeks	9.89%	7.63%
Being involved in bullying(as a bully) in the past 4 weeks	22.85%	22.98%
Primary care visit in the past 4 weeks for behavioral problems	15.00%	12.92%
Being invited to social activity in the past 4 weeks	60.14%	54.98%

Notes: Data were presented as percentage or mean (standard deviation) as appropriate.

* Significant at P < 0.05.

Abbreviations: BMI, body mass index; ADHD, attention-deficit/hyperactivitydisorder; CGI-ADHD, Clinical Global Impressions-ADHD-Severity; CSI-4, Child Symptom Inventory-4 Parent Checklist; SD, standard deviation.

Table 2 Association between overall adherence during follow-up and baseline patient characteristics

Variables	ORa	OR 95% CI	P-value
Age	0.993	0.918, 1.075	0.8703
Year at first symptoms	0.954	0.876, 1.040	0.2856
Male	0.709	0.438, 1.149	0.1629
Being from East Asia (versus Central Europe)*	0.549	0.361, 0.836	0.0051
Having birth problems	1.286	0.862, 1.919	0.2179
Family history of ADHD	0.806	0.545, 1.192	0.2802
Being involved in bullying (as a bully)	0.773	0.497, 1.203	0.2547
CGI-ADHD	1.057	0.876, 1.275	0.5650
BMI	0.957	0.908, 1.008	0.0972
Having other children living at home*	1.658	1.124, 2.446	0.0108
Parental emotional problems	0.818	0.554, 1.209	0.3139

Notes:

* Significant at P < 0.05.

a OR >1 indicates a positive association with overall adherence.

Abbreviations: ADHD, attention-deficit/hyperactivity disorder; BMI, body mass index; CGI-ADHD, Clinical Global Impressions-ADHD-Severity; CI, confidence interval; OR, odds ratio.

Table 3 Summary of associations between adherence to ADHD medication and subsequent outcomes during follow-up

Outcomes	OR	95% CI	P-value
Responsea	1.516 Estimates	1.140, 2.017 95% CI	0.0042 P-value
Change in clinical severityb
CGI-ADHD	−0.353	−0.506, −0.200	<0.001
CSI-4 A category	−2.980	−4.787, −1.172	0.0012
Change in CHIP-CE five domainsc
Satisfaction	1.507	−0.011, 3.025	0.0517
Comfort	0.988	−0.590, 2.565	0.2198
Risk avoidance	0.958	−0.592, 2.507	0.2257
Resilience	1.213	−0.223, 2.649	0.0977
Achievement	0.192	−1.096, 1.479	0.7705

Notes:

a OR >1 indicates a higher odds of achieving response in adherent patients;

b estimate <0 indicates greater improvement in clinical severity among adherent patients;

c estimate >0 indicates greater improvement in health-related quality of life (CHIP-CE) among adherent patients.

Abbreviations: ADHD, Attention-Deficit/Hyperactivity Disorder; OR, odds ratio; CI, confidence interval; CGI-ADHD, Clinical Global Impressions-ADHD-Severity; CSI-4, Child Symptom Inventory-4 Parent Checklist; CHIP-CE, Child Health and Illness Profile-Child Edition.