Medication adherence and persistence in children and adolescents with attention deficit hyperactivity disorder (ADHD): a systematic review and qualitative update

Ferrin, Maite, Hage, Alexander, Swanson, James, Wong, Kirstie, Dittmann, Ralf, Banaschewski, Tobias, Coghill, David, Santosh, Paramala, Romanos, Marcel, Simonoff, Emily, Buitelaar, Jan, European ADHD Guidelines Group (EAGG) and Thapar, Anita ORCID: https://orcid.org/0000-0002-3689-737X 2025. Medication adherence and persistence in children and adolescents with attention deficit hyperactivity disorder (ADHD): a systematic review and qualitative update. European Child and Adolescent Psychiatry 34 (3) , pp. 867-882. 10.1007/s00787-024-02538-z

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Abstract

Low medication-adherence and persistence may reduce the effectiveness of ADHD-medication. This preregistered systematic review (PROSPERO CRD42020218654) on medication-adherence and persistence in children and adolescents with ADHD focuses on clinically relevant questions and extends previous reviews by including additional studies. We included a total of n = 66 studies. There was a lack of consistency in the measurement of adherence/persistence between studies. Pooling the medication possession ratios (MPR) and using the most common adherence definition (MPR ≥ 80%) indicated that only 22.9% of participants had good adherence at 12-month follow-up. Treatment persistence on medication measured by treatment duration during a 12-month follow-up averaged 170 days (5.6 months). Our findings indicate that medication-adherence and persistence among youth with ADHD are generally poor and have not changed in recent years. Clinicians need to be aware that various factors may contribute to poor adherence/persistence and that long-acting stimulants and psychoeducational programs may help to improve adherence/persistence. However, the evidence to whether better adherence/persistence contributes to better long-term outcomes is limited and requires further research.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Schools > Medicine Research Institutes & Centres > MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG)
Publisher:	Springer
ISSN:	1018-8827
Date of First Compliant Deposit:	23 July 2024
Date of Acceptance:	15 July 2024
Last Modified:	06 Aug 2025 01:45
URI:	https://orca.cardiff.ac.uk/id/eprint/170856

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