Treatment of ADHD in adults – prevalence of discontinuation and associated factors – results from a cross-sectional analysis of Danish register data

Abstract

Background

A growing number of adults are receiving pharmacological treatment for ADHD but a sizable proportion also discontinues or have gaps in treatment. The primary aims of this study were to identify how many patients treated for ADHD in adulthood, have at least one event of discontinuation in treatment and to identify possible associated variables.

Methods

Within the Danish population aged 18–60 years on the 1st of January 2013, we identified the number of individuals who had been prescribed ADHD-medication at least once during the 1st of January 2002–31st of December 2013 using Danish register data. Among those who filed more than one prescription, treatment discontinuation was defined as having more than 211 days between two prescriptions. In crude and adjusted logistic regression analysis, we explored potential associations to discontinuation for variables such as gender and age at treatment initiation.

Results

In a population, if N = 3,165,844 individuals, n = 42,892 had received at least one prescription for ADHD medication. Among those with more than one prescription (N = 38,289), 29.4% had discontinued their treatment at least once, according to our definition of treatment discontinuation. ADHD treatment discontinuation was associated with being male, unemployment, lower educational attainment, receiving incapacity benefits and younger age at treatment initiation (p < 0.001).

Conclusions

A large proportion of individuals treated for ADHD had at least one discontinuation of treatment according to our definition. Although the present study does not allow for investigating the direction of these effects, nor whether some patients later resumed treatment, having at least one discontinuation was associated with a range of variables relating to e.g. age and gender, and provides an emerging profile for clinicians of patients more likely to discontinue.

Keywords:

• ADHD
• treatment
• compliance
• discontinuation
• stability

Disclosure statement

Christina Mohr-Jensen has received speaker fees from HB Pharma, Medice and IcePharma. Anne-Mette Lange reports personal fees and non-financial support from Medice. Per Hove Thomsen has received speakers fee from HB Pharma and Shire. David Daley outside this submitted work reports grants, personal fees and non-financial support from Shire. Personal fees and non-financial support from Medice and Eli Lilly. Non-financial support from QbTech. Book royalties from Jessica Kingsley.

Additional information

Funding

Medice Nordic supported the initial phase of the project financially by paying for the costs of a data-extract from the registers. Medice Nordic funded the costs of a meeting between the authors of this paper. Medice Nordic had no influence on the analyses or the interpretation of results nor the writing of the manuscript. None of the authors received fees from the company for any aspects of analysing data or writing the paper.