Journal
EXPERT REVIEW OF PHARMACOECONOMICS & OUTCOMES RESEARCH
Volume 13, Issue 6, Pages 791-815Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1586/14737167.2013.841544
Keywords
attention-deficit; hyperactivity disorder; medication adherence; medication compliance; medication persistence; psychostimulant; review
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Suboptimal adherence to treatment regimens is a major obstacle to treatment efficacy and positive outcomes for patients. While poor adherence is common across a variety of chronic conditions, an area which presents unique challenges to clinicians and researchers is non-adherence among pediatric populations. These challenges are well illustrated by the management of attention-deficit/hyperactivity disorder (ADHD), a pervasive pediatric psychiatric condition. The average rates of non-adherence in children and adults ranged between 15 and 87%. Factors predicting increased adherence/persistence included the use of long-acting formulations, younger age, Caucasian background, family structure and the presence and treatment of comorbidities. Decreased adherence/persistence were predicted by multiple daily dosing, family history of ADHD, experiences of adverse effects, stigma and treatment inefficacy. The broad range of non-adherence rates identified reflects the complexities of adherence research in ADHD, and highlights the need for better standardization of adherence/persistence definitions and measurement approaches.
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