title: Naturalistic Pharmacotherapy Compliance among Pediatric Patients with Attention Deficit/Hyperactivity Disorder: a Study Based on Three-Year Nationwide Data.
abstract: We examined short- and long-term medication compliance among youth with attention-deficit hyperactivity disorder (ADHD), using data from the National Health Insurance database in Korea. Of the 5,699,202 6-14-year-old youth in 2008, we chose those with at least 1 medical claim containing an ICD-10 code for diagnosis of ADHD (F90.0) and no prescription for ADHD within the previous 365 days. We tracked the data every 6 months between 2008 and 2011, to determine treatment compliance among newly diagnosed, medicated patients. Further, we checked every 1 month of the 6 months after treatment commencement. Treatment continuity for each patient was calculated by sequentially counting the continuous prescriptions. For measuring compliance, we applied the medication possession ratio (MPR) as 0.6, 0.7, and 0.8, and the gap method as 15- and 30-days' intervals. There were 15,133 subjects; 11,934 (78.86%) were boys. Overall 6-month treatment compliance was 59.0%, 47.3%, 39.9%, 34.1%, 28.6%, and 23.1%. Monthly drop-out rates within the first 6 months were 20.6%, 6.5%, 4.7%, 3.7%, 3.0%, and 2.5%, respectively. When applying MPR more strictly or shorter gap days, treatment compliance lessened. This is the first nationwide report on 36-month treatment compliance of the whole population of 6-14-year-olds with ADHD. We found the beginning of the treatment, especially the first month, to be a critical period in pharmacotherapy. These results also suggest the importance of setting appropriate treatment adherence standards for patients with ADHD, considering the chronic course of ADHD.
authors.affiliation: Department of Psychiatry, Myongji Hospital, Seonam University College of Medicine, Goyang, Korea .
authors.forename: Minha
authors.identifier: 0000-0003-4924-1107
authors.initials: M
authors.lastname: Hong
authors.affiliation: Department of Psychiatry, Sanggyepaik Hospital School of Medicine, Inje University, Seoul, Korea .
authors.forename: Bongseog
authors.identifier: 0000-0002-2534-6986
authors.initials: B
authors.lastname: Kim
authors.affiliation: Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Korea .
authors.forename: Jun-Won
authors.identifier: 0000-0001-5407-8514
authors.initials: JW
authors.lastname: Hwang
authors.affiliation: Department of Psychiatry, Eulji University, College of Medicine, Seoul, Korea .
authors.forename: Soo-Young
authors.identifier: 0000-0001-5254-0314
authors.initials: SY
authors.lastname: Bhang
authors.affiliation: Department of Biostatistics, Graduate School of Public Health, Seoul National University, Seoul, Korea .
authors.forename: Hyung Yun
authors.identifier: 0000-0002-6134-3504
authors.initials: HY
authors.lastname: Choi
authors.affiliation: Department of Preventive Medicine, Kyung Hee University, School of Medicine, Seoul, Korea .
authors.forename: In-Hwan
authors.identifier: 0000-0002-5450-9887
authors.initials: IH
authors.lastname: Oh
authors.affiliation: Department of Psychiatry, Soonchunhyang University, School of Medicine, Seoul, Korea .
authors.forename: Yeon Jung
authors.identifier: 0000-0002-5624-0447
authors.initials: YJ
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, Kyung Hee University, School of Medicine, Seoul, Korea .
authors.forename: Geon Ho
authors.identifier: 0000-0002-3550-0422
authors.initials: GH
authors.lastname: Bahn
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D002648:Child; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008774:Methylphenidate / Q000627:therapeutic use*; D056910:Republic of Korea; D012189:Retrospective Studies
chemical_list: D000697:Central Nervous System Stimulants; D008774:Methylphenidate
keywords: Attention Deficit Disorder with Hyperactivity; Compliance; Medication Adherence; National Health Programs