title: Factors predicting treatment adherence in patients with adult attention-deficit/hyperactivity disorder: a preliminary study.
abstract: This study aimed to elicit patient- and treatment-related factors that can potentially predict treatment adherence in adult ADHD. Subjects who were over 18 and received a diagnosis of ADHD were included in the study. Chart review data of 102 subjects regarding demographics, medications, comorbidities, concomitant medications and domains of functional impairment were collected, and predictors were assessed using a binominal logistical regression model. One hundred and two patients (78.4 % male) with a mean age of 28.8 (SD = 9.8, range = 18-55) years were enrolled in the study. Childhood diagnosis of ADHD, agents used for treatment (MPH or atomoxetine), individual domains of dysfunction and use of additional psychotropic drugs were not found to be related to treatment adherence. Patients with a university education and those referred for family history of ADHD were more likely to adhere to treatment (p = 0.05 and 0.03, respectively). On the other hand, reasons for referral other than ADHD were significantly more frequently related to non-adherence (p = 0.02). Treatment noncompliance remains a significant problem despite therapeutic effects of medications. Identification of predictors of non-adherence can lead to heightened awareness of special populations at risk. We have found that prior awareness on ADHD (via past history/media/friends) leading to self/clinician referral to rule out ADHD and pervasiveness of symptoms across functional domains led to better compliance in our sample. Future research with prospective design utilizing objective tools for adherence is required.
authors.affiliation: Bengi Semerci Enstitusu, Istanbul, Turkey.
authors.forename: Bengi
authors.initials: B
authors.lastname: Semerci
authors.affiliation: Department of Psychiatry, Koç University School of Medicine, Rumelifeneri Yolu, Sarıyer, 34550, Istanbul, Turkey. ataskiran@ku.edu.tr.
authors.forename: Sarper
authors.initials: S
authors.lastname: Taskıran
authors.affiliation: Department of Child and Adolescent Psychiatry, Abant Izzet Baysal University, Bolu, Turkey.
authors.forename: Evren
authors.initials: E
authors.lastname: Tufan
authors.affiliation: Bengi Semerci Enstitusu, Istanbul, Turkey.
authors.forename: Işın
authors.initials: I
authors.lastname: Şanlı
mesh_terms: D000293:Adolescent; D000328:Adult; D000069445:Atomoxetine Hydrochloride / Q000627:therapeutic use; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000523:psychology*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008774:Methylphenidate / Q000627:therapeutic use; D008875:Middle Aged; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000697:Central Nervous System Stimulants; D008774:Methylphenidate; D000069445:Atomoxetine Hydrochloride
keywords: Adult ADHD; Pharmacology; Treatment adherence; Treatment compliance