본문 바로가기
KERD
논문KCI 등재

국내 주의력결핍 과잉행동 장애 아동 및 청소년의 약물요법 패턴 및 지속성

Patterns and Persistence of Pharmacotherapy for Children and Adolescents with Attention Deficit Hyperactivity Disorder in South Korea

1

조회

0

다운로드

0

인용

0

참고문헌

키워드

주제분류약학

초록

Objective: This study aimed to assess treatment persistence in Korean children and adolescents with attention deficit hyperactivitydisorder (ADHD) and the factors influencing their adherence to ADHD pharmacotherapy. Methods: The study included patientsbetween 6 and 18 years of age with ADHD who were taking various formulations of methylphenidate and atomoxetine on June 1,2014. Patients were dichotomized as “persistent” or “non-persistent”, depending on whether they continued ADHD therapy for 6months (therapy persistence). We also investigated if the patients were taking the same medication(s) as before and also classifiedthe patients as “medication persistent” or “non-persistent”. Patient’ characteristics were correlated with therapy persistence andmedication persistence. Multiple logistic regression analyses were performed to assess potential risk factors for treatmentpersistence. Results: Overall, 3,317 patients were included in the analysis. A majority of patients were taking stimulants (82.0%),16.2% were taking non-stimulants and 1.8% were taking a combination therapy of stimulants and non-stimulants. After 6 months,2,290 patients (69.0%) continued to take medication for ADHD with 1,953 patients taking the same medication(s) as 6 monthspreviously. Common positive factors for therapy persistence and medication persistence were identified as younger age,retardation, and developmental delay, and long-acting formulations of methylphenidate as either monotherapy or in a combinationtherapy may be used. Conclusion: ADHD medications were proven to improve academic performance and social skills of children. Collaboration between patients, parents, school staffs, and prescribers is required to improve the persistent use of ADHDmedications.

Abstract

Objective: This study aimed to assess treatment persistence in Korean children and adolescents with attention deficit hyperactivitydisorder (ADHD) and the factors influencing their adherence to ADHD pharmacotherapy. Methods: The study included patientsbetween 6 and 18 years of age with ADHD who were taking various formulations of methylphenidate and atomoxetine on June 1,2014. Patients were dichotomized as “persistent” or “non-persistent”, depending on whether they continued ADHD therapy for 6months (therapy persistence). We also investigated if the patients were taking the same medication(s) as before and also classifiedthe patients as “medication persistent” or “non-persistent”. Patient’ characteristics were correlated with therapy persistence andmedication persistence. Multiple logistic regression analyses were performed to assess potential risk factors for treatmentpersistence. Results: Overall, 3,317 patients were included in the analysis. A majority of patients were taking stimulants (82.0%),16.2% were taking non-stimulants and 1.8% were taking a combination therapy of stimulants and non-stimulants. After 6 months,2,290 patients (69.0%) continued to take medication for ADHD with 1,953 patients taking the same medication(s) as 6 monthspreviously. Common positive factors for therapy persistence and medication persistence were identified as younger age,retardation, and developmental delay, and long-acting formulations of methylphenidate as either monotherapy or in a combinationtherapy may be used. Conclusion: ADHD medications were proven to improve academic performance and social skills of children. Collaboration between patients, parents, school staffs, and prescribers is required to improve the persistent use of ADHDmedications.

참고문헌 (52)

  1. "Diagnostic and statistical manual of mental disorders (<TEX>$DSM-5^{(R)}$</TEX>), American Psychiatric Pub"[URL]
  2. Subcommittee on Attention-Deficit, "Hyperactivity D", ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit, Pediatrics, pp.2011, 128[DOI]
  3. Polanczyk G, "The worldwide prevalence of ADHD: a systematic review and metaregression analysis", Am J Psychiatry, 164, pp.942~948 (2007)[DOI]
  4. Polanczyk GV, "ADHD prevalence estimates across three decades: an updated systematic review and metaregression analysis", Int J Epidemiol, 43, pp.434~442 (2014)[DOI]
  5. Willcutt EG, "The prevalence of DSM-IV attention-deficit", hyperactivity disorder: a meta-analytic review, 2012, pp.9, 490~499
  6. Faraone SV, "The worldwide prevalence of ADHD: is it an American condition?", World Psychiatry, 2, pp.104~113 (2003)
  7. 양수진, "주의력 결핍 과잉 행동 장애의 유병률과 관련 인자 : 서울시 학교 정신보건 사업", 신경정신의학, 45(1), pp.69~76 (2006), 대한신경정신의학회
  8. Cho S-C, "Prevalence of disruptive behavior disorders", J Korean Acad Child Adolesc Psychiatry, 5, pp.141~149 (1994)
  9. Kim JY, "An epidemiological study of attention-deficits hyperactivity disorder and learning disabilities in a rural area", J Korean Neuropsychiatr Assoc, 38, pp.784~793 (1999)
  10. Reports of epidemiological study, "Center SCaAMH", ~ (2005)
  11. Yoon Huh, "A Comparison of Comorbidity and Psychological Outcomes in Children and Adolescents with Attention-Deficit", Hyperactivity Disorder, 2011, pp.8(2), 95~101[DOI]
  12. Ambrosini PJ, "Attention deficit hyperactivity disorder characteristics: II. Clinical correlates of irritable mood", J Affect Disord, 145, pp.70~76 (2013)[DOI]
  13. Bussing R, "Adolescent outcomes of childhood attention-deficit", hyperactivity disorder in a diverse community sample, 2010, pp.49, 595~605
  14. Jensen PS, "Findings from the NIMH Multimodal Treatment Study of ADHD (MTA): implications and applications for primary care providers", J Dev Behav Pediatr, 22, pp.60~73 (2001)[DOI]
  15. Larson K, "Patterns of comorbidity, functioning, and service use for US children with ADHD, 2007", Pediatrics, 127, pp.462~470 (2011)[DOI]
  16. Group MC, "A 14-month randomized clinical trial of treatment strategies for attention-deficit", hyperactivity disorder, 1999, pp.56, 1073~1086
  17. Pliszka SR, "Comorbidity of attention-deficit", hyperactivity disorder with psychiatric disorder: an overview, 1998, pp.59, 50~58
  18. Biederman J, "Evidence-based pharmacotherapy for attention-deficit hyperactivity disorder", Int J Neuropsychopharmacol, 7, pp.77~97 (2004)[DOI]
  19. Briars L, "A Review of Pharmacological Management of Attention-Deficit", Hyperactivity Disorder, 2016, pp.21, 192~206
  20. Spencer T, "Pharmacotherapy of attention-deficit hyperactivity disorder across the life cycle", J Am Acad Child Adolesc Psychiatry, 35, pp.409~432 (1996)[DOI]
  21. Meijer WM, "Current issues around the pharmacotherapy of ADHD in children and adults", Pharm World Sci, 31, pp.509~516 (2009)[DOI]
  22. Gajria K, "Adherence, persistence, and medication discontinuation in patients with attention-deficit", hyperactivity disorder - a systematic literature review, 2014, pp.10, 1543~1569
  23. Lara C, "Childhood predictors of adult ADHD: results from the WHO World Mental Health (WMH) Survey Initiative", Biol Psychiatry, 65, pp.46~54 (2009)[DOI]
  24. McCarthy S, "Attention-deficit hyperactivity disorder: treatment discontinuation in adolescents and young adults", Br J Psychiatry, 194, pp.273~277 (2009)[DOI]
  25. McCarthy S, "Persistence of pharmacological treatment into adulthood, in UK primary care, for ADHD patients who started treatment in childhood or adolescence", BMC Psychiatry, 12, pp.219~ (2012)[DOI]
  26. Kim L, "A guide for the utilization of Health Insurance Review and Assessment Service National Patient Samples", Epidemiol Health, 36, pp.e2014008~ (2014)
  27. Ahmed R, "Attention-deficit", hyperactivity disorder: an update on medication adherence and persistence in children, adolescents and adults, 2013, pp.13, 791~815
  28. Wang LJ, "Initiation and Persistence of Pharmacotherapy for Youths with Attention Deficit Hyperactivity Disorder in Taiwan", PLoS One, 11, pp.e0161061~ (2016)[DOI]
  29. Ho PM, "Medication Adherence. Its Importance in Cardiovascular Outcomes", Circulation, 119, pp.3028~3035 (2009)[DOI]
  30. Halpern MT, "Recommendations for Evaluating Compliance and Persistence With Hypertension Therapy Using Retrospective Data", Hypertension, 47, pp.1039~1048 (2006)[DOI]
  31. Ayaz M, "Medication Persistence in Turkish Children and Adolescents with Attention-Deficit", Hyperactivity Disorder, 2014, pp.24, 442~447
  32. Winterstein AG, "Utilization of pharmacologic treatment in youths with attention deficit", hyperactivity disorder in Medicaid database, 2008, pp.42, 24~31
  33. Garbe E, "Drug treatment patterns of attention-deficit", hyperactivity disorder in children and adolescents in Germany: results from a large population-based cohort study, 2012, pp.22, 452~458
  34. McCarthy S, "Persistence of pharmacological treatment into adulthood, in UK primary care, for ADHD patients who started treatment in childhood or adolescence", BMC psychiatry, 12, pp.1~ (2012)[DOI]
  35. Atzori P, "Predictive factors for persistent use and compliance of immediate-release methylphenidate: a 36-month naturalistic study", J Child Adolesc Psychopharmacol, 19, pp.673~681 (2009)[DOI]
  36. Park J, "Comorbidity and Factors Affecting Treatment Non-Persistence in ADHD", J Atten Disord (2015)
  37. Miller VA, "Decision-making competence and adherence to treatment in adolescents with diabetes", J Pediatr Psychol, 32, pp.178~88 (2007)
  38. Chacko A, "Improving medication adherence in chronic pediatric health conditions: a focus on ADHD in youth", Curr Pharm Des, 16, pp.2416~2423 (2010)[DOI]
  39. van den Ban E, "Less discontinuation of ADHD drug use since the availability of long-acting ADHD medication in children, adolescents and adults under the age of 45 years in the Netherlands", Atten Defic Hyperact Disord, 2, pp.213~220 (2010)[DOI]
  40. Atzori P, "Predictive factors for persistent use and compliance of immediate-release methylphenidate: a 36-month naturalistic study", J Child Adolesc Psychopharmacol, 19, pp.673~681 (2009)[DOI]
  41. Baucom KJ, "Depressive symptoms, daily stress, and adherence in late adolescents with type 1 diabetes", Health Psychol, 34, pp.522~ (2015)[DOI]
  42. DiMatteo MR, "Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence", Arch Intern Med, 160, pp.2101~2107 (2000)[DOI]
  43. Wing RR, "The role of adherence in mediating the relationship between depression and health outcomes", J Psychosom Res, 53, pp.877~881 (2002)[DOI]
  44. Raman SR, "An observational study of pharmacological treatment in primary care of children with ADHD in the United Kingdom", Psychiatr Serv, 66, pp.617~624 (2015)[DOI]
  45. Lawson KA, "Utilization patterns of stimulants in ADHD in the Medicaid population: a retrospective analysis of data from the Texas Medicaid program", Clin Ther, 34, pp.944~956 (2012)[DOI]
  46. 방수영, "Differences in Utilization Patterns among Medications in Children and Adolescents with Attention-Deficit", Hyperactivity Disorder: a 36-Month Retrospective Study Using the Korean Health Insurance Review and Assessment Claims Database, 2016, pp.31(8), 1284~1291[DOI]
  47. Gau SS-F, "An open-label, randomized, active-controlled equivalent trial of osmotic release oral system methylphenidate in children with attention-deficit", hyperactivity disorder in Taiwan, 2006, pp.16, 441~455
  48. Steele M, "A randomized, controlled effectiveness trial of OROS-methylphenidate compared to usual care with immediate-release methylphenidate in attention deficit-hyperactivity disorder", Can J Clin Pharmacol, 13, pp.e50~e62 (2006)
  49. Charach A, "Enhancing ADHD medication adherence: challenges and opportunities", Curr Psychiatry Rep, 15, pp.371~ (2013)[DOI]
  50. Rezaei G, "Comparative efficacy of methylphenidate and atomoxetine in the treatment of attention deficit hyperactivity disorder in children and adolescents: A systematic review and meta-analysis", Med J Islam Repub Iran, 30, pp.325~ (2016)
  51. Lawson KA, "Utilization patterns of stimulants in ADHD in the Medicaid population: a retrospective analy- sis of data from the Texas Medicaid program", Clin Ther, 34, pp.944~956 (2012)[DOI]
  52. Gajria K, "Adherence, persistence, and medication discontinuation in patients with attention-deficit", hyperactivity disorder-a systematic literature review, 2014, pp.10, 1543~1569

관련 논문AI추천

Prescribing patterns for attention deficit hyperactivity disorder medications among children and adolescents in Korea, 2007-2011송인명, 신주영한국역학회 · Epidemiology and Health2016 · 제38권 Factors that Affect the Adherence to ADHD Medications during a Treatment Continuation Period in Children and Adolescents: A Nationwide Retrospective Cohort Study Using Korean Health Insurance Data from 2007 to 2011곽영숙, 김봉석, 반건호, 방수영, 손석한, 양재원, 오인환, 이소영, 이연정, 정운선, 정유숙, 최형윤, 홍민하, 황준원대한신경정신의학회 · PSYCHIATRY INVESTIGATION2017 · 제14권 제2호ADHD 아동·청소년의 약물치료에 대한 고찰이상훈한국정서행동장애학회 · 정서·행동장애연구2021 · 제37권 제4호국민건강보험 데이터베이스를 이용한 한국의 소아와 성인에서 주의력결핍 과잉행동장애의 진단율 및 약물 사용 추세 연구경장재, 남범우, 서정석, 서정철대한신경정신의학회 · 신경정신의학2021 · 제60권 제4호Combined Medication with Stimulants and Non-stimulants for Attention-deficit/hyperactivity Disorder반건호, Kyunghoon Seo대한정신약물학회 · Clinical Psychopharmacology and Neuroscience2021 · 제19권 제4호Differences in the Clinical Characteristics of Remission and Non-Remission Groups with Once-Daily OROS-Methylphenidate Treatment of Attention-Deficit/Hyperactivity Disorder육기환, 윤형준, 이상혁, 최태규, 홍나래, 홍현주대한정신약물학회 · Clinical Psychopharmacology and Neuroscience2008 · 제6권 제1호

이 간행물의 다른 논문 (11건)