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芬兰儿童和青少年多动症药物治疗的持续时间——一项全国性登记研究

Duration of ADHD medication treatment among Finnish children and adolescents ‒ a nationwide register study.

作者信息

Kolari Terhi A, Vuori Miika, Rättö Hanna, Varimo Eveliina A, Aronen Eeva T, Auranen Kari, Saastamoinen Leena K, Ruokoniemi Päivi T

机构信息

Department of Biostatistics and Turku University Hospital, University of Turku, Turku, Finland.

Department of Biostatistics, University of Turku, Turku, 20014, Finland.

出版信息

Eur Child Adolesc Psychiatry. 2025 May 7. doi: 10.1007/s00787-025-02735-4.

Abstract

AIM

To study the duration of attention-deficit/hyperactivity disorder (ADHD) medication treatment among children and adolescents by sex and age group in Finland during 2008-2019.

METHODS

This was a descriptive, population-based register study covering all Finnish children and adolescents aged 6-18 years who initiated their first ADHD medication treatment period between January 1, 2008 and December 31, 2019 (n = 40691). To establish the duration of use we collected data from the register of Dispensations reimbursable under the National Health Insurance Scheme register. The median follow-up time was 3.8 years (Q1 = 1.7, Q3 = 7.1). Treatment duration was calculated as the interval between the date of the first and last purchase with a cut-off of 365 days allowed between purchases. The durations were estimated using Kaplan-Meier survival times.

RESULTS

The median duration of ADHD medication treatment was 3.2 years (95% CI 3.2, 3.3, Q1 = 1.0 95% CI 0.9, 1.0, Q3 = 6.8 95% CI 6.7, 7.0). Sex and age significantly influenced treatment duration (p <.0001 and p <.0001). Boys had longer treatment duration than girls and the younger the subject, the longer the duration of usage. Boys aged 6-8 years (32.4% of the subjects) exhibited the longest treatment duration with a median of 6.3 years (95% CI 6.2, 6.5, Q1 = 2.6 95% CI 2.5, 2.7, Q3 = 9.4 years 95% CI 9.2, 9.6).

CONCLUSIONS

The duration of ADHD medication treatment among children in the real-world clinical setting goes well beyond the data available from randomized controlled trials and extends for several years especially among young boys.

摘要

目的

研究2008年至2019年芬兰儿童和青少年注意力缺陷多动障碍(ADHD)药物治疗的持续时间,并按性别和年龄组进行分析。

方法

这是一项基于人群的描述性登记研究,涵盖了2008年1月1日至2019年12月31日期间开始首个ADHD药物治疗期的所有6至18岁芬兰儿童和青少年(n = 40691)。为确定用药持续时间,我们从国家健康保险计划可报销配药登记册中收集数据。中位随访时间为3.8年(第一四分位数Q1 = 1.7,第三四分位数Q3 = 7.1)。治疗持续时间计算为首次和最后一次购买日期之间的间隔,两次购买之间允许间隔365天。使用Kaplan-Meier生存时间估计持续时间。

结果

ADHD药物治疗的中位持续时间为3.2年(95%置信区间3.2,3.3,Q1 = 1.0 95%置信区间0.9,1.0,Q3 = 6.8 95%置信区间6.7,7.0)。性别和年龄对治疗持续时间有显著影响(p <.0001和p <.0001)。男孩的治疗持续时间比女孩长,且受试者年龄越小,用药持续时间越长。6至8岁的男孩(占受试者的32.4%)治疗持续时间最长,中位时间为6.3年(95%置信区间6.2,6.5,Q1 = 2.6 95%置信区间2.5,2.7,Q3 = 9.4年95%置信区间9.2,9.6)。

结论

在现实临床环境中,儿童ADHD药物治疗的持续时间远远超过随机对照试验中的数据,且会持续数年,尤其是在年幼男孩中。

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