Clinicians frequently describe incomplete adherence to stimulant medication as a limitation to the effectiveness of treating ADHD in adolescents. This study examined reported adherence among 44 adolescents prescribed medication for symptoms of attention deficit hyperactivity disorder (ADHD). Reports of medication adherence were obtained from adolescents and parents at two time points, approximately two months apart. Parent and adolescent reports indicated reasonable agreement, with parents and adolescents reporting high rates of adherence at both time points (medians ranged from 85 to 89% adherence). A small group of adolescents reported extremely low rates of adherence, but we were not able to distinguish this group from the remainder of the sample based on demographics. It is argued that the sample is generally representative of adolescents who are being prescribed medication for ADHD, and that the high adherence rates are valid. These findings imply that clinicians treating adolescents with ADHD should be cautious in assuming that medication adherence is an inevitable problem in this population.
AACAP Official Action Committee
. (1997). Summary of the practice parameters for the assessment and treatment of children, adolescents, adults with ADHD. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1311-1317.
2.
Achenbach, T. M.
(1991). Manual for the Child Behavior Checklist/4-18 and 1991 Profile. Burlington: University of Vermont Department of Psychiatry.
3.
Barkley, R. A.
, Fischer, M., Edelbrock, C. S., & Smallish, L. (1990). The adolescent outcome of hyperactive children diagnosed by research criteria: I. An 8-year prospective follow-up study. Journal of the American Academy of Child and Adolescent Psychiatry, 29, 546-557.
4.
Barrickman, L. L.
, Perry, P. J., Allen, A. J., Kuperman, S., Arndt, S. V., Herrmann, K. J., & Schumacher, E. (1995). Bupropion versus methylphenidate in the treatment of attention- deficit hyperactivity disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 649-657.
5.
Bastiaens, L.
(1995). Compliance with pharmacotherapy in adolescents: Effects of patients’ and parents’ knowledge and attitudes toward treatment. Journal of Child and Adolescent Psychopharmacology, 5, 39-48.
6.
Biederman, J.
, Newcorn, J., & Sprich, S. (1991). Comorbidity of attention deficit hyperactivity disorder with conduct, depressive, anxiety, and other disorders. American Journal of Psychiatry, 148, 564-577.
7.
Brown, R. T.
, Borden, K. A., & Clingerman, S. R. (1985). Adherence to methylphenidate therapy in a pediatric population: A preliminary investigation. Psychopharmacology Bulletin, 21, 28-36.
8.
Brownlee-Duffeck, M.
, Peterson, L., Simonds, J. F., Goldstein, D., Kilo, C., & Hoette, S. (1987). The role of health beliefs in the regimen adherence and metabolic control of adolescents and adults with diabetes mellitus. Journal of Consulting and Clinical Psychology, 55, 139-144.
9.
Christiaanse, M. E.
, Lavigne, J. V., & Lerner, C. V. (1989). Psychosocial aspects of compliance in children and adolescents with asthma. Journal of Developmental and Behavioral Pediatrics, 10, 75-80.
10.
Cramer, J. A.
, & Rosenheck, R. (1998). Compliance with medication regimens for mental and physical disorders. Psychiatric Services, 49, 196-201.
11.
Cromer, B. A.
, & Tarnowski, K. (1989). Noncompliance in adolescents: A review. Developmental and Behavioral Pediatrics, 10, 207-215.
12.
Dunbar-Jacob, J.
, Dunning, J. E., & Dwyer, K. (1993). Compliance research in pediatric and adolescent populations: Two decades of research. In N. A. Krasnegor, L. Epstein, S. B. Johnson, & S.J. Yaffe (Eds.), Developmental aspects of health compliance behavior(pp. 29-51). Hillsdale, NJ: Erlbaum.
13.
Epstein, L. H.
, & Cluss, P. A. (1982). A behavioral medicine perspective on adherence to long-term medical regimens. Journal of Consulting and Clinical Psychology, 50, 950-971.
14.
Evans, S. W.
, & Pelham, W. E. (1991). Psychostimulant effects on academic and behavioral measures for ADHD junior high school students in a lecture format classroom. Journal of Abnormal Child Psychology, 19, 537-551.
15.
Firestone, P.
(1982). Factors associated with children’s adherence to stimulant medication. American Journal of Orthopsychiatry, 52, 447-457.
16.
Greenhill, L. L.
(1992). Pharmacologic treatment of attention deficit hyperactivity disorder. Pediatric Psychopharmacology, 15(1), 1-27.
17.
Hazzard, A.
, Hutchinson, S. J., & Krawiecki, N. (1990). Factors related to adherence to medication regimens in pediatric seizure patients. Journal of Pediatric Psychology, 15, 543-555.
18.
Hechtman, L.
(1985). Adolescents outcome of hyperactive children treated with stimulants in childhood: a review. Psychopharmacology Bulletin, 21, 178-191.
19.
Johnston, C.
, & Fine, S. (1993). Methods of evaluating methylphenidate in children with attention deficit hyperactivity disorder: Acceptability, satisfaction, and compliance. Journal of Pediatric Psychology, 18, 717-730.
20.
Korsch, B. M.
, Fine, R. N., & Negrete, V. F. (1978). Noncompliance in children with renal transplants. Pediatrics, 61, 872-876.
21.
Kovacs, M.
, Goldston, D., Obrosky, D. S., & Iyengar, S. (1992). Prevalence and Predictors of pervasive noncompliance with medical treatment among youths with insulin-dependent diabetes mellitus. The Journal of American Academy of Child and Adolescent Psychiatry, 31, 1112-1119.
22.
Lemanek, K.
(1990). Adherence issues in the medical management of asthma. Journal of Pediatric Psychology, 15, 437-458.
23.
Manne, S. L.
(1998). Treatment adherence and compliance. In R. T. Ammerman and J. V. Campo (Eds.), Handbook of pediatric psychology and psychiatry, (vol. 2). (pp. 103-131). Needham Heights, MA: Allyn & Bacon.
24.
Murphy, D. A.
, & Pelham, W. E. (1989). Attention Deficit Disorder. In L.K.G. Hsu and M. Hersen (Eds.) Recent developments in adolescent psychiatry. (pp. 234-267). New York: John Wiley & Sons.
25.
Rappoport, J. L.
, Buchsbaun, M. S., Zahn, T. P., Weingartner, H., Ludlow, C., & Mikkelsen, E. J. (1978). Dextroamphetamine: Cognitive and behavioral effects in normal prepubertal boys. Science, 199, 560-563.
26.
Richters, J. E.
, Arnold, L. E., Jensen, P. S., Abikoff, H., Conners, C. K., Greenhill, L. L., Hechtman, L., Hinshaw, S. P., Pelham, W. E., & Swanson, J. M. (1995). NIMH collaborative multisite multimodal treatment study of children with ADHD: I. Background and rationale. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 987-1000.
27.
Sackett, D. L.
(1976). The magnitude of compliance and noncompliance. In D. L. Sackett & R. B. Haynes (Eds.), Compliance with therapeutic regimens. Baltimore, MD: Johns Hopkins University Press.
28.
Satterfield, J. H.
, Hoppe, C. M., & Schell, A. M. (1982). A prospective study of delinquency in 110 adolescent boys with attention deficit disorder and 88 normal adolescent boys. American Journal of Psychiatry, 139, 795-798.
29.
Sleator, E. K.
, Ullmann, R. K., & von Neumann, A. (1982). How do hyperactive children feel about taking stimulants and will they tell the doctor?Clinical Pediatrics, 11, 474-479.
30.
Spencer, T.
, Biederman, J., Wilens, T., Harding, M., O’Donnell, D., & Griffin, S. (1996). Pharmacotherapy of attention-deficit hyperactivity disorder across the life cycle. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 409-432.
31.
Strahan, R.
, & Gerbasi, K. C. (1972). Short, homogeneous versions of the Marlow-Crowne Social Desirability Scale. Journal of Clinical Psychology, 28, 191-193.
32.
Tebbi, C. K.
(1992). Treatment compliance in childhood and adolescence. Cancer, 71, 3441-3449.
33.
Tebbi, C. K.
, Cummings, K. M., Zevon, M. A., Smith, L., Richards, M., & Mallon, J. (1986). Compliance of pediatric and adolescent cancer patients. Cancer, 58, 1179-1184.
34.
Varley, C. K.
& Trupin, E. W. (1983). Double-blind assessment of stimulant medication for attention deficit disorder: A model for clinical application. American Journal of Orthopsychiatry, 53, 542-547.
35.
Wilson, J. M.
, & Marcotte, A. C. (1996). Psychosocial adjustment and educational outcome in adolescents with a childhood diagnosis of attention deficit disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 579-587.
