Patterns of ADHD Medicine Use: A Population-based Study Among Australian Children and Adults (2013-2020)

Saturday, August 27, 2022

1:30 PM – 1:45 PM CEST

Location: C1M0

Publication Number: 171

Background: New therapeutic options such as lisdexamfetamine and guanfacine have recently become available for treatment of attention deficit hyperactivity disorder (ADHD).

Objectives: We described contemporary patterns of ADHD medicine use among children, adolescents, and adults in Australia.

Methods: This population-based study used dispensing data for a 10% random sample of Australian residents between July 2012 and December 2020. We estimated the annual prevalence and incidence of ADHD medicines, second-line guanfacine use, and examined concurrent medicine use of both stimulant and non-stimulants. We followed incident users for up to 5 years and analysed treatment persistence using a novel proportion of people covered method. Analyses were stratified by ADHD medicine, sex, and age group; young children (0-5 years), children (6-12 years), adolescents (13-17 years), young adults (18-24 years), and adults (≥25 years).

Results: We observed a two-fold increase in the overall prevalence of ADHD medicine use between 2013 and 2020, from 4.9 to 9.7 per 1,000 persons. Incident use also increased across all age groups and both sexes, with most pronounced increases among adolescent females (from 1.4 to 5.3 per 1,000 persons). Stimulant treatment persistence after 5 years was highest among those initiating treatment as young children (64%) and children (69%) and lowest among those initiating treatment in adolescence (19%). Concurrent use of stimulants and non-stimulants was more common among males and younger age groups. Most children (87%) initiating guanfacine had prior dispensings of ADHD medicines.

Conclusions: We observed increasing ADHD medicine use in Australia, especially among young females. Nevertheless, treatment rates remained lower than the estimated prevalence of ADHD across all subpopulations. Poor long-term treatment persistence in adolescence may warrant improved clinical monitoring of ADHD in patients transitioning from pediatric to adult care. Reassuringly, use of newly approved guanfacine appeared to be in accordance with guidelines among children.

Presenting Author(s)

Claudia Bruno, BSc

PhD Candidate
School of Population Health, UNSW Sydney
Sydney, New South Wales, Australia

Slides

Co-Author(s)

AH

Alys Havard

National Drug and Alcohol Research Centre, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia, Australia
MG

Malcolm Gillies, BSc (Hons), PhD, MBiostat

Senior Biostatistician
Centre for Big Data Research in Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia, Australia
DC

David Coghill

Departments of Paediatrics and Psychiatry, Faculty of Medicine Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia, Australia
JB

Jonathan Brett

Centre for Big Data Research in Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia, Australia
AG

Adam Guastella

Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia, Australia
SP

Sallie-Anne Pearson, PhD

Director, Centre of Research Excellence in Medicines Intelligence
Centre for Big Data Research in Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia, New South Wales, Australia
HZ

Helga Zoega

Centre for Big Data Research in Health, Faculty of Medicine and Health, University of New South Wales, Sydney, Australia, Australia