Short- and Long-Term Outcomes of Suboptimal Medication Adherence in Adolescents with Attention-Deficit/Hyperactivity Disorder: A Systematic Literature Review
Restricted accessReview articleFirst published online May, 2024
Short- and Long-Term Outcomes of Suboptimal Medication Adherence in Adolescents with Attention-Deficit/Hyperactivity Disorder: A Systematic Literature Review
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition with severe and life-long consequences. Adolescents and young adults represent a particularly vulnerable subgroup because of the unique demands of their developmental stage. Despite the well-known efficacy of medication treatment for ADHD, there remains a notable concern regarding poor medication adherence in this population.
Objectives:
This systematic literature review aimed to synthesize the existing empirical evidence on the outcomes and consequences of medication nonadherence among adolescents and young adults with ADHD.
Methods:
An extensive database search was conducted on September 26, 2022, with no time limits applied. The databases included Scopus, PubMed, CINAHL, Cochrane, and PsycINFO.
Results:
Six studies met the inclusion criteria. Each study revealed that medication nonadherence was associated with a range of adverse outcomes, including decreased academic performance, heightened familial, and psychological stress, and an increased likelihood of substance use, pregnancy, obesity, and injury. Conversely, adherence led to improvements in at least one ADHD-related outcome.
Conclusions:
Research exploring the consequences of suboptimal medication adherence in adolescents and young adults with ADHD is currently limited, and effective strategies to address this issue remain scarce. A thorough understanding of such consequences is critical for developing interventions aimed at improving medication adherence and mitigating the risk of adverse outcomes, especially considering the susceptibility of this population.
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References
1.
AdlerLD, NierenbergAA. Review of medication adherence in children and adults with ADHD. Postgrad Med, 2010; 122(1):184–191; doi: 10.3810/pgm.2010.01.2112
2.
ArnoldLE, HodgkinsP, KahleJ, et al.Long-term outcomes of ADHD: Academic achievement and performance. J Atten Disord, 2020; 24(1):73–85; doi: 10.1177/1087054714566076
3.
Association AP. Diagnostic and statistical manual of mental disorders. 2022.
4.
Barnard-BrakL, RobertsB, ValenzuelaE. Examining breaks and resistance in medication adherence among adolescents with ADHD as associated with school outcomes. J Atten Disord, 2020; 24(8):1148–1155; doi: 10.1177/1087054718763738
5.
BiedermanJ, FriedR, DiSalvoM, et al.Evidence of low adherence to stimulant medication among children and youths with ADHD: An electronic health records study. Psychiatr Serv, 2019; 70(10):874–880; doi: 10.1176/appi.ps.201800515
6.
BolandH, DiSalvoM, FriedR, et al.A literature review and meta-analysis on the effects of ADHD medications on functional outcomes. J Psychiatr Res, 2020; 123:21–30; doi: 10.1016/j.jpsychires.2020.01.006
7.
BusbyKK, SajatovicM. REVIEW: Patient, treatment, and systems-level factors in bipolar disorder nonadherence: A summary of the literature. CNS Neurosci Ther, 2010; 16(5):308–315; doi: 10.1111/j.1755-5949.2010.00191.x
8.
ChakrabartiS. Treatment alliance and adherence in bipolar disorder. World J Psychiatry, 2018; 8(5):114–124; doi: 10.5498/wjp.v8.i5.114
9.
CherkasovaMV, RoyA, MolinaBSG, et al.Review: Adult outcome as seen through controlled prospective follow-up studies of children with attention-deficit/hyperactivity disorder followed into adulthood. J Am Acad Child Adolesc Psychiatry, 2022; 61(3):378–391; doi: 10.1016/j.jaac.2021.05.019
10.
ChungWW, HudziakJJ. The transitional age brain: “The Best of Times and the Worst of Times. Child Adolesc Psychiatr Clin N Am, 2017; 26(2):157–175; doi: 10.1016/j.chc.2016.12.017
11.
CoghillDR, BanaschewskiT, SoutulloC, et al.Systematic review of quality of life and functional outcomes in randomized placebo-controlled studies of medications for attention-deficit/hyperactivity disorder. Eur Child Adolesc Psychiatry, 2017; 26(11):1283–1307; doi: 10.1007/s00787-017-0986-y
12.
CorteseS, AdamoN, Del GiovaneC, et al.Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: A systematic review and network meta-analysis. Lancet Psychiatry, 2018; 5(9):727–738; doi: 10.1016/s2215-0366(18)30269-4
13.
CutlerAJ, MattinglyGW, JainR, et al.Current and future nonstimulants in the treatment of pediatric ADHD: Monoamine reuptake inhibitors, receptor modulators, and multimodal agents. CNS Spectr, 2022; 27(2):199–207; doi: 10.1017/S1092852920001984
14.
DekkersTJ, HuizengaHM, PopmaA, et al.Decision-making deficits in adolescent boys with and without attention-deficit/hyperactivity disorder (ADHD): An experimental assessment of associated mechanisms. J Abnorm Child Psychol, 2020; 48(4):495–510; doi: 10.1007/s10802-019-00613-7
15.
DochertyJR, AlsufyaniHA. Pharmacology of drugs used as stimulants. J Clin Pharmacol, 2021; 61 Suppl 2(2):S53–S69; doi: 10.1002/jcph.1918
16.
EmilssonM, GustafssonPA, ÖhnströmG, et al.Beliefs regarding medication and side effects influence treatment adherence in adolescents with attention deficit hyperactivity disorder. Eur Child Adolesc Psychiatry, 2017; 26(5):559–571; doi: 10.1007/s00787-016-0919-1
17.
FarhatLC, FloresJM, BehlingE, et al.The effects of stimulant dose and dosing strategy on treatment outcomes in attention-deficit/hyperactivity disorder in children and adolescents: A meta-analysis. Mol Psychiatry, 2022; 27(3):1562–1572; doi: 10.1038/s41380-021-01391-9
18.
ForthunLF, SajatovicM, LevinJB, et al.Modification of an intervention to improve adherence in adolescents and young adults with bipolar disorder. JAACAP Open, 2023; 1(2):80–92; doi: 10.1016/j.jaacop.2023.04.001
19.
GauSS, ChenSJ, ChouWJ, et al.National survey of adherence, efficacy, and side effects of methylphenidate in children with attention-deficit/hyperactivity disorder in Taiwan. J Clin Psychiatry, 2008; 69(1):131–140; doi: 10.4088/jcp.v69n0118
20.
GauSS, ShenHY, ChouMC, et al.Determinants of adherence to methylphenidate and the impact of poor adherence on maternal and family measures. J Child Adolesc Psychopharmacol, 2006; 16(3):286–297; doi: 10.1089/cap.2006.16.286
21.
GroenmanAP, OosterlaanJ, RommelseNN, et al.Stimulant treatment for attention-deficit hyperactivity disorder and risk of developing substance use disorder. Br J Psychiatry, 2013; 203(2):112–119; doi: 10.1192/bjp.bp.112.124784
22.
HarpinV, MazzoneL, RaynaudJP, et al.Long-term outcomes of ADHD: A systematic review of self-esteem and social function. J Atten Disord, 2016; 20(4):295–305; doi: 10.1177/1087054713486516
23.
IshizuyaA, EnomotoM, TachimoriH, et al.Risk factors for low adherence to methylphenidate treatment in pediatric patients with attention-deficit/hyperactivity disorder. Sci Rep, 2021; 11(1):1707; doi: 10.1038/s41598-021-81416-z
24.
LeebensPK, WilliamsonED. Developmental psychopathology: Risk and resilience in the transition to young adulthood. Child Adolesc Psychiatr Clin N Am, 2017; 26(2):143–156; doi: 10.1016/j.chc.2016.12.001
25.
LevinJB, KrivenkoA, HowlandM, et al.Medication Adherence in Patients with Bipolar Disorder: A Comprehensive Review. CNS Drugs, 2016; 30(9):819–835; doi: 10.1007/s40263-016-0368-x
26.
LibutzkiB, MayM, GleitzM, et al.Disease burden and direct medical costs of incident adult ADHD: A retrospective longitudinal analysis based on German statutory health insurance claims data. Eur Psychiatry, 2020; 63(1):e86; doi: 10.1192/j.eurpsy.2020.84
27.
Ltd VHI. Covidence systematic review software. Veritas Health Innovation, Melbourne, Australia. 2024. Available from: www.covidence.org [Last accessed: March25, 2024].
28.
McVoyM, DelbelloM, LevinJ, et al.A customized adherence enhancement program for adolescents and young adults with suboptimal adherence and bipolar disorder: Trial design and methodological report. Contemp Clin Trials, 2022; 115:106729; doi: 10.1016/j.cct.2022.106729
29.
World Health Organization. Adherence to long-term therapies: Evidence for action. 2003.
30.
PaiMS, YangSN, ChuCM, et al.Risk of injuries requiring hospitalization in attention deficit hyperactivity disorder and the preventive effects of medication. Psychiatry Clin Neurosci, 2022; 76(12):652–658; doi: 10.1111/pcn.13471
31.
RaoK, CarpenterDM, CampbellCI. Attention-deficit/hyperactivity disorder medication adherence in the transition to adulthood: Associated adverse outcomes for females and other disparities. J Adolesc Health, 2021; 69(5):806–814; doi: 10.1016/j.jadohealth.2021.04.025
32.
SchaeferMR, RawlinsonAR, WagonerST, et al.Adherence to attention-deficit/hyperactivity disorder medication during the transition to college. J Adolesc Health, 2017; 60(6):706–713; doi: 10.1016/j.jadohealth.2016.12.011
33.
ShawM, HodgkinsP, CaciH, et al.A systematic review and analysis of long-term outcomes in attention deficit hyperactivity disorder: Effects of treatment and non-treatment. BMC Med, 2012; 10:99; doi: 10.1186/1741-7015-10-99
34.
SinghA, YehCJ, VermaN, et al.Overview of attention deficit hyperactivity disorder in young children. Health Psychol Res, 2015; 3(2):2115; doi: 10.4081/hpr.2015.2115
35.
ThompsonL, McCabeR. The effect of clinician-patient alliance and communication on treatment adherence in mental health care: A systematic review. BMC Psychiatry, 2012; 12:87; doi: 10.1186/1471-244X-12-87
36.
TreuerT, MéndezL, MontgomeryW, et al.Factors affecting treatment adherence to atomoxetine in ADHD: A systematic review. Neuropsychiatr Dis Treat, 2016; 12:1061–1083; doi: 10.2147/NDT.S97724
37.
VertessenK, LumanM, StaffA, et al.Meta-analysis: Dose-dependent effects of methylphenidate on neurocognitive functioning in children with attention-deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry, 2022; 61(5):626–646; doi: 10.1016/j.jaac.2021.08.023
38.
WeismanO, SchonherzY, HarelT, et al.Testing the efficacy of a smartphone application in improving medication adherence, among children with ADHD. Isr J Psychiatry, 2018; 55(2):59–63.
39.
WellsG, SheaB, O’ConnellD, et al.The newcastle–Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. 2021. Available from: www.ohri.ca/programs/clinical_epidemiology/oxford.asp [Last accessed: August , 13].
40.
WolraichML, HaganJF, AllanC, et al.Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics, 2019; 144(4); doi: 10.1542/peds.2019-2528
41.
ZurM, MagneziR, PortugueseS, et al.The impact of adherence to treatment for ADHD on the quality of military service—The Israeli military experience. Mil Med, 2018; 183(9–10):e518–e524; doi: 10.1093/milmed/usy161
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