Further evidence of low adherence to stimulant treatment in adult ADHD: an electronic medical record study examining timely renewal of a stimulant prescription

• Published in: Psychopharmacology 2020-09, Vol.237 (9), p.2835-2843
• Main Authors: Biederman, Joseph, Fried, Ronna, DiSalvo, Maura, Woodworth, K. Yvonne, Biederman, Itai, Driscoll, Haley, Noyes, Elizabeth, Faraone, Stephen V., Perlis, Roy H.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Adults; Attention Deficit Disorder with Hyperactivity - drug therapy; Attention Deficit Disorder with Hyperactivity - psychology; Attention deficit hyperactivity disorder; Biomedical and Life Sciences; Biomedicine; Central Nervous System Stimulants - therapeutic use; Drug Prescriptions; Drug therapy; Electronic Health Records - trends; Electronic medical records; Electronic records; Female; Humans; Male; Medical records; Medical research; Medication Adherence - psychology; Medicine, Experimental; Neurosciences; Original Investigation; Patient compliance; Patients; Pharmacology/Toxicology; Psychiatry; Stimulants; Time Factors; Young Adult
• ISSN: 0033-3158; 1432-2072
• DOI: 10.1007/s00213-020-05576-y

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.