title: Differences in Utilization Patterns among Medications in Children and Adolescents with Attention-Deficit/Hyperactivity Disorder: a 36-Month Retrospective Study Using the Korean Health Insurance Review and Assessment Claims Database.
abstract: We evaluated the differences in utilization patterns including persistence and adherence among medications in children and adolescents with attention deficit hyperactivity disorder (ADHD). The current study was performed using data from the Korean Health Insurance Review and Assessment claims database from January 1, 2009 to December 31, 2013. Our study sample consisted of 10,343 children and adolescents with ADHD who were not given their newly prescribed medication in 360 days before the initial claim in 2010. Data were followed up from the initiation of treatment with ADHD medications in 2010 to December 31, 2013. Discontinuation rates for 4 ADHD medications in our sample ranged from 97.7% for immediate-release methylphenidate to 99.4% for atomoxetine using refill gap more than 30 days and from 56.7% for immediate-release methylphenidate to 62.3% for extended-release methylphenidate using refill gap more than 60 days. In the number of discontinued, we found significant differences among medications using refill gap more than 30 days. Among 4 ADHD medications, extended-release methylphenidate and atomoxetine had more days than immediate-release methylphenidate and osmotic-controlled oral delivery system methylphenidate. In logistic regression analyses, extended-release methylphenidate, osmotic-controlled oral delivery system methylphenidate, and atomoxetine showed less discontinuation compared to immediate-release methylphenidate group when a refill gap more than 30 days was used. In logistic regression analysis of adherence, we could not find any differences among 4 medication types. We suggest that the utilization patterns should be assessed regularly in order to improve future outcomes in children and adolescents with ADHD.
authors.affiliation: Department of Psychiatry, Eulji University School of Medicine, Eulji General Hospital, Seoul, Korea .
authors.forename: Soo-Young
authors.identifier: 0000-0001-5254-0314
authors.initials: SY
authors.lastname: Bhang
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, Jeju National University College of Medicine, Jeju, Korea .
authors.forename: Young-Sook
authors.identifier: 0000-0002-6071-238X
authors.initials: YS
authors.lastname: Kwak
authors.affiliation: Department of Psychiatry, Sungkyunkwan University School of Medicine, Seoul, Korea .
authors.forename: Yoo Sook
authors.identifier: 0000-0002-9225-4643
authors.initials: YS
authors.lastname: Joung
authors.affiliation: Department of Psychiatry, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon, Korea .
authors.forename: Soyoung
authors.identifier: 0000-0003-2473-2954
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, Inje University School of Medicine, Sanggyepaik Hospital, Seoul, Korea .
authors.forename: Bongseog
authors.identifier: 0000-0002-2534-6986
authors.initials: B
authors.lastname: Kim
authors.affiliation: Yonsei Clinic of Psychiatry, Seoul, Korea .
authors.forename: Seok Han
authors.identifier: 0000-0001-6130-9317
authors.initials: SH
authors.lastname: Sohn
authors.affiliation: Department of Psychiatry, Kyungpook National University School of Medicine, Daegu, Korea .
authors.forename: Un Sun
authors.identifier: 0000-0003-3871-1425
authors.initials: US
authors.lastname: Chung
authors.affiliation: Department of Psychiatry, KAIST Clinic, Daejeon, Korea .
authors.forename: Jaewon
authors.identifier: 0000-0001-5064-5948
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of Psychiatry, Myungji General Hospital, Goyang, Korea .
authors.forename: Minha
authors.identifier: 0000-0003-4924-1107
authors.initials: M
authors.lastname: Hong
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
authors.affiliation: Korean Centers for Disease Control and Prevention, Cheongju, 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 College of Medicine, Seoul Hospital, Seoul, Korea .
authors.forename: Yeon Jung
authors.identifier: 0000-0002-5624-0447
authors.initials: YJ
authors.lastname: Lee
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000069445:Atomoxetine Hydrochloride / Q000627:therapeutic use; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D002648:Child; D016208:Databases, Factual; D004339:Drug Compounding; D005260:Female; D006801:Humans; D007345:Insurance Claim Review; D016015:Logistic Models; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use; D016017:Odds Ratio; D056910:Republic of Korea; D012189:Retrospective Studies; D016903:Drug Monitoring
chemical_list: D000697:Central Nervous System Stimulants; D008774:Methylphenidate; D000069445:Atomoxetine Hydrochloride
keywords: Atomoxetine; Attention Deficit Hyperactivity Disorder; Medication Adherence; Methylphenidate