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 NeumannVirginia 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

    Research output: Contribution to journalArticle

    20 Citations (Scopus)

    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
    Pages (from-to)824-835
    Number of pages12
    JournalLancet Psychiatry
    Volume5
    Issue number10
    DOIs
    Publication statusPublished - Oct 2018

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    Attention Deficit Disorder with Hyperactivity
    Observational Studies
    Retrospective Studies
    Databases
    Population
    North America
    Guidelines
    Methylphenidate
    Safety

    Cite this

    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: Lancet Psychiatry. 2018 ; Vol. 5, No. 10. pp. 824-835.
    @article{d0e150d7ea9f49ffb6441264e363e570,
    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 Yea-Huei KaoYang 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 Chien-Chou Su and Helga Zoega and Sturkenbroom, {Miriam C J M} and Chan, {Esther W} and David Coghill and Patrick Ip and Wong, {Ian C K}",
    note = "Copyright {\circledC} 2018 Elsevier Ltd. All rights reserved.",
    year = "2018",
    month = "10",
    doi = "10.1016/S2215-0366(18)30293-1",
    language = "English",
    volume = "5",
    pages = "824--835",
    journal = "Lancet Psychiatry",
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    Raman, SR, Man, KKC, Bahmanyar, S, Berard, A, Bilder, S, Boukhris, T, Bushnell, G, Crystal, S, Furu, K, KaoYang, Y-H, Karlstad, Ø, Kieler, H, Kubota, K, Lai, EC-C, 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, C-C, 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', 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: Lancet Psychiatry, Vol. 5, No. 10, 10.2018, p. 824-835.

    Research output: Contribution to journalArticle

    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

    N1 - Copyright © 2018 Elsevier Ltd. All rights reserved.

    PY - 2018/10

    Y1 - 2018/10

    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 - Article

    C2 - 30220514

    VL - 5

    SP - 824

    EP - 835

    JO - Lancet Psychiatry

    JF - Lancet Psychiatry

    SN - 2215-0366

    IS - 10

    ER -