Centre for Pharmacoepidemiology and Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, SE-171 76 Stockholm, Sweden; Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.
Eur Neuropsychopharmacol. 2013 Dec;23(12):1732-8. doi: 10.1016/j.euroneuro.2013.07.009. Epub 2013 Aug 1.
The aim of this study was to describe the pediatric population with ADHD and their pharmacological treatment. Using the Swedish National Patient Register and the Prescribed Drug Register we identified individuals below 19 years of age who were diagnosed or medically treated for ADHD for the first time 2006-2007. The unique patient identifiers were used to link information from the two registers to describe demographic characteristics, hospital care and drug treatments. Logistic regression model estimated the association between age, sex, frequency of hospitalization, diagnosis or treatment for other mental disorders and risk of gap in the treatment. Totally the study included 7931 patients of whom 74% were males. The mean age at first diagnosis was 12 years. Some 84% were medically treated for ADHD and approximately 90% received methylphenidate as the first substance. Combination therapy was rare and the most common combination was methylphenidate and atomoxetine. More than 55% of the patients, which could be followed up for two years after start of treatment, had at least one treatment gap of six months. Older age at diagnosis, lower number of hospitalizations and comorbidity with other mental disorders increased risks of gaps in medication. Approximately one fifth of the patients recorded in the National Patient Register as diagnosed with ADHD did not receive pharmacological treatment. Medication adherence seems to be low, when measured as gaps in treatment.
本研究旨在描述患有注意力缺陷多动障碍(ADHD)的儿科人群及其药物治疗情况。我们使用瑞典国家患者登记处和处方药物登记处,确定了在 2006-2007 年首次被诊断或接受 ADHD 药物治疗的 19 岁以下人群。通过独特的患者识别码,我们将两个登记处的信息联系起来,以描述人口统计学特征、医院护理和药物治疗情况。逻辑回归模型估计了年龄、性别、住院频率、其他精神障碍的诊断或治疗与治疗中断风险之间的关联。研究共纳入了 7931 名患者,其中 74%为男性。首次诊断的平均年龄为 12 岁。约 84%的患者接受了 ADHD 的药物治疗,约 90%的患者接受了哌醋甲酯作为首选药物。联合治疗较为罕见,最常见的联合用药是哌醋甲酯和托莫西汀。超过 55%的患者在开始治疗后的两年内至少有一次长达六个月的药物治疗中断。诊断时年龄较大、住院次数较少以及合并其他精神障碍会增加药物治疗中断的风险。大约五分之一在国家患者登记处记录为患有 ADHD 的患者未接受药物治疗。药物依从性似乎较低,以治疗中断来衡量。