Abstract
This study aimed to examine the resumption of attention-deficit hyperactivity disorder (ADHD) prescriptions in early adulthood in young people whose ADHD prescriptions stopped in adolescence. Whilst prescribing studies indicate that the proportion of those with ADHD stopping treatment in late adolescence remains in excess of the proportion expected to be symptom free, very few studies have examined patterns of resumption amongst young adults previously prescribed medication. Primary care records from the UK Clinical Practice Research Datalink from 2008 to 2013 were used to examine the outcome of resumption of ADHD prescriptions from age 20 years in a sample of cases with ADHD whose prescriptions stopped aged 14–18 years. A Cox regression model was fitted to explore variables that could theoretically be associated with resumption of prescriptions. Of 1440 cases, 109 (7.6%) had their ADHD prescriptions resumed. Characteristics associated with an increased probability of resumption included female gender, learning disability, referral to adult mental health services, and prescription of antipsychotic medication. In this study, only a small proportion of adolescents who stopped ADHD medication subsequently resumed their prescriptions in primary care. Those that did resume were a more complex group. As many vulnerable individuals with ongoing ADHD symptoms may not have the resources required to surmount the barriers to re-enter services, the implication is that not all those who could benefit from resuming medication are able to do so. The findings raise questions around whether current care models are flexible enough and whether primary care services are adequately supported in managing this group.
Highlights
Attention-deficit hyperactivity disorder (ADHD) is accepted to be a condition which can persist throughout life
We aimed to explore resumption of ADHD medication prescriptions in early adulthood amongst young people whose prescriptions stopped in adolescence using primary care prescribing data from the UK Clinical Practice Research Datalink from 2005 to 2013
This study was a secondary analysis of data from the Clinical Practice Research Datalink (CPRD), a large UK clinical database run by the Medicines and Healthcare Products Regulatory Agency (MHRA)
Summary
Attention-deficit hyperactivity disorder (ADHD) is accepted to be a condition which can persist throughout life. Follow-up studies suggest that up to three-quarters of young people diagnosed as children continue to experience symptoms into adulthood, even if they no longer meet full diagnostic criteria [1]. These symptoms, which include inattention, impulsivity, and hyperactivity, can undermine the fulfilment of adult responsibilities such as further education, employment, intimate relationships and parenting, and are associated with risk-taking behaviours, accidents and injuries [2,3,4,5]. External factors may influence ongoing prescribing, such as a lack of services or expertise to oversee medication management in adults, or a lack of support, resource and preparation for transition to adult services that leads both services and young people to disengage even before the age boundary for the service is reached [14,15,16]
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