Trends in attention-deficit hyperactivity disorder medication use

a retrospective observational study using population-based databases

Sudha R. Raman, Kenneth K.C. Man, Shahram Bahmanyar, Anick Berard, Scott Bilder, Takoua Boukhris, Greta Bushnell, Stephen Crystal, Kari Furu, Yea Huei KaoYang, Øystein Karlstad, Helle Kieler, Kiyoshi Kubota, Edward Chia Cheng Lai, Jaana E. Martikainen, Géric Maura, Nicholas Moore, Dolores Montero, Hidefumi Nakamura, Anke Neumann & 13 others Virginia Pate, Anton Pottegård, Nicole L. Pratt, Elizabeth E. Roughead, Diego Macias Saint-Gerons, Til Stürmer, Chien Chou Su, Helga Zoega, Miriam C.J.M. Sturkenbroom, Esther W. Chan, David Coghill, Patrick Ip, Ian C.K. Wong

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Abstract

Background: The use of medications to treat attention deficit hyperactivity disorder (ADHD) has increased, but the prevalence of ADHD medication use across different world regions is not known. Our objective was to determine regional and national prevalences of ADHD medication use in children and adults, with a specific focus on time trends in ADHD medication prevalence. Methods: We did a retrospective, observational study using population-based databases from 13 countries and one Special Administrative Region (SAR): four in Asia and Australia, two in North America, five in northern Europe, and three in western Europe. We used a common protocol approach to define study populations and parameters similarly across countries and the SAR. Study populations consisted of all individuals aged 3 years or older between Jan 1, 2001, and Dec 31, 2015 (dependent on data availability). We estimated annual prevalence of ADHD medication use with 95% CI during the study period, by country and region and stratified by age and sex. We reported annual absolute and relative percentage changes to describe time trends. Findings: 154·5 million individuals were included in the study. ADHD medication use prevalence in 2010 (in children aged 3–18 years) varied between 0·27% and 6·69% in the countries and SAR assessed (0·95% in Asia and Australia, 4·48% in North America, 1·95% in northern Europe, and 0·70% in western Europe). The prevalence of ADHD medication use among children increased over time in all countries and regions, and the absolute increase per year ranged from 0·02% to 0·26%. Among adults aged 19 years or older, the prevalence of any ADHD medication use in 2010 varied between 0·003% and 1·48% (0·05% in Asia and Australia, 1·42% in North America, 0·47% in northern Europe, and 0·03% in western Europe). The absolute increase in ADHD medication use prevalence per year ranged from 0·0006% to 0·12%. Methylphenidate was the most commonly used ADHD medication in most countries. Interpretation: Using a common protocol and data from 13 countries and one SAR, these results show increases over time but large variations in ADHD medication use in multiple regions. The recommendations of evidence-based guidelines need to be followed consistently in clinical practice. Further research is warranted to describe the safety and effectiveness of ADHD medication in the short and long term, and to inform evidence-based guidelines, particularly in adults. Funding: None

Original languageEnglish
JournalThe lancet. Psychiatry
Volume5
Issue number10
Pages (from-to)824-835
ISSN2215-0366
DOIs
Publication statusPublished - 1. Oct 2018

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Retrospective Studies
Databases
Population
North America
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Raman, Sudha R. ; Man, Kenneth K.C. ; Bahmanyar, Shahram ; Berard, Anick ; Bilder, Scott ; Boukhris, Takoua ; Bushnell, Greta ; Crystal, Stephen ; Furu, Kari ; KaoYang, Yea Huei ; Karlstad, Øystein ; Kieler, Helle ; Kubota, Kiyoshi ; Lai, Edward Chia Cheng ; Martikainen, Jaana E. ; Maura, Géric ; Moore, Nicholas ; Montero, Dolores ; Nakamura, Hidefumi ; Neumann, Anke ; Pate, Virginia ; Pottegård, Anton ; Pratt, Nicole L. ; Roughead, Elizabeth E. ; Macias Saint-Gerons, Diego ; Stürmer, Til ; Su, Chien Chou ; Zoega, Helga ; Sturkenbroom, Miriam C.J.M. ; Chan, Esther W. ; Coghill, David ; Ip, Patrick ; Wong, Ian C.K. / Trends in attention-deficit hyperactivity disorder medication use : a retrospective observational study using population-based databases. In: The lancet. Psychiatry. 2018 ; Vol. 5, No. 10. pp. 824-835.
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title = "Trends in attention-deficit hyperactivity disorder medication use: a retrospective observational study using population-based databases",
abstract = "Background: The use of medications to treat attention deficit hyperactivity disorder (ADHD) has increased, but the prevalence of ADHD medication use across different world regions is not known. Our objective was to determine regional and national prevalences of ADHD medication use in children and adults, with a specific focus on time trends in ADHD medication prevalence. Methods: We did a retrospective, observational study using population-based databases from 13 countries and one Special Administrative Region (SAR): four in Asia and Australia, two in North America, five in northern Europe, and three in western Europe. We used a common protocol approach to define study populations and parameters similarly across countries and the SAR. Study populations consisted of all individuals aged 3 years or older between Jan 1, 2001, and Dec 31, 2015 (dependent on data availability). We estimated annual prevalence of ADHD medication use with 95{\%} CI during the study period, by country and region and stratified by age and sex. We reported annual absolute and relative percentage changes to describe time trends. Findings: 154·5 million individuals were included in the study. ADHD medication use prevalence in 2010 (in children aged 3–18 years) varied between 0·27{\%} and 6·69{\%} in the countries and SAR assessed (0·95{\%} in Asia and Australia, 4·48{\%} in North America, 1·95{\%} in northern Europe, and 0·70{\%} in western Europe). The prevalence of ADHD medication use among children increased over time in all countries and regions, and the absolute increase per year ranged from 0·02{\%} to 0·26{\%}. Among adults aged 19 years or older, the prevalence of any ADHD medication use in 2010 varied between 0·003{\%} and 1·48{\%} (0·05{\%} in Asia and Australia, 1·42{\%} in North America, 0·47{\%} in northern Europe, and 0·03{\%} in western Europe). The absolute increase in ADHD medication use prevalence per year ranged from 0·0006{\%} to 0·12{\%}. Methylphenidate was the most commonly used ADHD medication in most countries. Interpretation: Using a common protocol and data from 13 countries and one SAR, these results show increases over time but large variations in ADHD medication use in multiple regions. The recommendations of evidence-based guidelines need to be followed consistently in clinical practice. Further research is warranted to describe the safety and effectiveness of ADHD medication in the short and long term, and to inform evidence-based guidelines, particularly in adults. Funding: None",
author = "Raman, {Sudha R.} and Man, {Kenneth K.C.} and Shahram Bahmanyar and Anick Berard and Scott Bilder and Takoua Boukhris and Greta Bushnell and Stephen Crystal and Kari Furu and KaoYang, {Yea Huei} and {\O}ystein Karlstad and Helle Kieler and Kiyoshi Kubota and Lai, {Edward Chia Cheng} and Martikainen, {Jaana E.} and G{\'e}ric Maura and Nicholas Moore and Dolores Montero and Hidefumi Nakamura and Anke Neumann and Virginia Pate and Anton Potteg{\aa}rd and Pratt, {Nicole L.} and Roughead, {Elizabeth E.} and {Macias Saint-Gerons}, Diego and Til St{\"u}rmer and Su, {Chien Chou} and Helga Zoega and Sturkenbroom, {Miriam C.J.M.} and Chan, {Esther W.} and David Coghill and Patrick Ip and Wong, {Ian C.K.}",
year = "2018",
month = "10",
day = "1",
doi = "10.1016/S2215-0366(18)30293-1",
language = "English",
volume = "5",
pages = "824--835",
journal = "The Lancet Psychiatry",
issn = "2215-0366",
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Raman, SR, Man, KKC, Bahmanyar, S, Berard, A, Bilder, S, Boukhris, T, Bushnell, G, Crystal, S, Furu, K, KaoYang, YH, Karlstad, Ø, Kieler, H, Kubota, K, Lai, ECC, Martikainen, JE, Maura, G, Moore, N, Montero, D, Nakamura, H, Neumann, A, Pate, V, Pottegård, A, Pratt, NL, Roughead, EE, Macias Saint-Gerons, D, Stürmer, T, Su, CC, Zoega, H, Sturkenbroom, MCJM, Chan, EW, Coghill, D, Ip, P & Wong, ICK 2018, 'Trends in attention-deficit hyperactivity disorder medication use: a retrospective observational study using population-based databases', The lancet. Psychiatry, vol. 5, no. 10, pp. 824-835. https://doi.org/10.1016/S2215-0366(18)30293-1

Trends in attention-deficit hyperactivity disorder medication use : a retrospective observational study using population-based databases. / Raman, Sudha R.; Man, Kenneth K.C.; Bahmanyar, Shahram; Berard, Anick; Bilder, Scott; Boukhris, Takoua; Bushnell, Greta; Crystal, Stephen; Furu, Kari; KaoYang, Yea Huei; Karlstad, Øystein; Kieler, Helle; Kubota, Kiyoshi; Lai, Edward Chia Cheng; Martikainen, Jaana E.; Maura, Géric; Moore, Nicholas; Montero, Dolores; Nakamura, Hidefumi; Neumann, Anke; Pate, Virginia; Pottegård, Anton; Pratt, Nicole L.; Roughead, Elizabeth E.; Macias Saint-Gerons, Diego; Stürmer, Til; Su, Chien Chou; Zoega, Helga; Sturkenbroom, Miriam C.J.M.; Chan, Esther W.; Coghill, David; Ip, Patrick; Wong, Ian C.K.

In: The lancet. Psychiatry, Vol. 5, No. 10, 01.10.2018, p. 824-835.

Research output: Contribution to journalJournal articleResearchpeer-review

TY - JOUR

T1 - Trends in attention-deficit hyperactivity disorder medication use

T2 - a retrospective observational study using population-based databases

AU - Raman, Sudha R.

AU - Man, Kenneth K.C.

AU - Bahmanyar, Shahram

AU - Berard, Anick

AU - Bilder, Scott

AU - Boukhris, Takoua

AU - Bushnell, Greta

AU - Crystal, Stephen

AU - Furu, Kari

AU - KaoYang, Yea Huei

AU - Karlstad, Øystein

AU - Kieler, Helle

AU - Kubota, Kiyoshi

AU - Lai, Edward Chia Cheng

AU - Martikainen, Jaana E.

AU - Maura, Géric

AU - Moore, Nicholas

AU - Montero, Dolores

AU - Nakamura, Hidefumi

AU - Neumann, Anke

AU - Pate, Virginia

AU - Pottegård, Anton

AU - Pratt, Nicole L.

AU - Roughead, Elizabeth E.

AU - Macias Saint-Gerons, Diego

AU - Stürmer, Til

AU - Su, Chien Chou

AU - Zoega, Helga

AU - Sturkenbroom, Miriam C.J.M.

AU - Chan, Esther W.

AU - Coghill, David

AU - Ip, Patrick

AU - Wong, Ian C.K.

PY - 2018/10/1

Y1 - 2018/10/1

N2 - Background: The use of medications to treat attention deficit hyperactivity disorder (ADHD) has increased, but the prevalence of ADHD medication use across different world regions is not known. Our objective was to determine regional and national prevalences of ADHD medication use in children and adults, with a specific focus on time trends in ADHD medication prevalence. Methods: We did a retrospective, observational study using population-based databases from 13 countries and one Special Administrative Region (SAR): four in Asia and Australia, two in North America, five in northern Europe, and three in western Europe. We used a common protocol approach to define study populations and parameters similarly across countries and the SAR. Study populations consisted of all individuals aged 3 years or older between Jan 1, 2001, and Dec 31, 2015 (dependent on data availability). We estimated annual prevalence of ADHD medication use with 95% CI during the study period, by country and region and stratified by age and sex. We reported annual absolute and relative percentage changes to describe time trends. Findings: 154·5 million individuals were included in the study. ADHD medication use prevalence in 2010 (in children aged 3–18 years) varied between 0·27% and 6·69% in the countries and SAR assessed (0·95% in Asia and Australia, 4·48% in North America, 1·95% in northern Europe, and 0·70% in western Europe). The prevalence of ADHD medication use among children increased over time in all countries and regions, and the absolute increase per year ranged from 0·02% to 0·26%. Among adults aged 19 years or older, the prevalence of any ADHD medication use in 2010 varied between 0·003% and 1·48% (0·05% in Asia and Australia, 1·42% in North America, 0·47% in northern Europe, and 0·03% in western Europe). The absolute increase in ADHD medication use prevalence per year ranged from 0·0006% to 0·12%. Methylphenidate was the most commonly used ADHD medication in most countries. Interpretation: Using a common protocol and data from 13 countries and one SAR, these results show increases over time but large variations in ADHD medication use in multiple regions. The recommendations of evidence-based guidelines need to be followed consistently in clinical practice. Further research is warranted to describe the safety and effectiveness of ADHD medication in the short and long term, and to inform evidence-based guidelines, particularly in adults. Funding: None

AB - Background: The use of medications to treat attention deficit hyperactivity disorder (ADHD) has increased, but the prevalence of ADHD medication use across different world regions is not known. Our objective was to determine regional and national prevalences of ADHD medication use in children and adults, with a specific focus on time trends in ADHD medication prevalence. Methods: We did a retrospective, observational study using population-based databases from 13 countries and one Special Administrative Region (SAR): four in Asia and Australia, two in North America, five in northern Europe, and three in western Europe. We used a common protocol approach to define study populations and parameters similarly across countries and the SAR. Study populations consisted of all individuals aged 3 years or older between Jan 1, 2001, and Dec 31, 2015 (dependent on data availability). We estimated annual prevalence of ADHD medication use with 95% CI during the study period, by country and region and stratified by age and sex. We reported annual absolute and relative percentage changes to describe time trends. Findings: 154·5 million individuals were included in the study. ADHD medication use prevalence in 2010 (in children aged 3–18 years) varied between 0·27% and 6·69% in the countries and SAR assessed (0·95% in Asia and Australia, 4·48% in North America, 1·95% in northern Europe, and 0·70% in western Europe). The prevalence of ADHD medication use among children increased over time in all countries and regions, and the absolute increase per year ranged from 0·02% to 0·26%. Among adults aged 19 years or older, the prevalence of any ADHD medication use in 2010 varied between 0·003% and 1·48% (0·05% in Asia and Australia, 1·42% in North America, 0·47% in northern Europe, and 0·03% in western Europe). The absolute increase in ADHD medication use prevalence per year ranged from 0·0006% to 0·12%. Methylphenidate was the most commonly used ADHD medication in most countries. Interpretation: Using a common protocol and data from 13 countries and one SAR, these results show increases over time but large variations in ADHD medication use in multiple regions. The recommendations of evidence-based guidelines need to be followed consistently in clinical practice. Further research is warranted to describe the safety and effectiveness of ADHD medication in the short and long term, and to inform evidence-based guidelines, particularly in adults. Funding: None

U2 - 10.1016/S2215-0366(18)30293-1

DO - 10.1016/S2215-0366(18)30293-1

M3 - Journal article

VL - 5

SP - 824

EP - 835

JO - The Lancet Psychiatry

JF - The Lancet Psychiatry

SN - 2215-0366

IS - 10

ER -