Treatment compliance or medication adherence in children and adolescents on ADHD medication in clinical practice: results from the COMPLY observational study

• Published in: Attention deficit and hyperactivity disorders Vol. 7; no. 2; pp. 165 - 174
• Main Authors: Wehmeier, Peter M., Dittmann, Ralf W., Banaschewski, Tobias
• Format: Journal Article
• Language: English
• Published: Vienna Springer Vienna 01.06.2015
• Subjects: Adolescent; Adrenergic Uptake Inhibitors - adverse effects; Adrenergic Uptake Inhibitors - therapeutic use; Atomoxetine Hydrochloride - adverse effects; Atomoxetine Hydrochloride - therapeutic use; Attention Deficit Disorder with Hyperactivity - drug therapy; Attention Deficit Disorder with Hyperactivity - psychology; Central Nervous System Stimulants - adverse effects; Central Nervous System Stimulants - therapeutic use; Child; Female; Humans; Male; Medication Adherence - psychology; Medicine; Medicine & Public Health; Methylphenidate - adverse effects; Methylphenidate - therapeutic use; Original Article; Prospective Studies; Psychiatry; Time Factors; Adherence; ADHD; Observational study; Atomoxetine; Compliance; Psychostimulants
• ISSN: 1866-6116; 1866-6647; 1866-6647
• DOI: 10.1007/s12402-014-0156-8

Although the efficacy and tolerability of ADHD medications have been investigated fairly extensively, there are very few data comparing the different types of medication (e.g. psychostimulants, non-stimulants) in terms of medication adherence. The primary research objective of the COMPLY observational study was to evaluate medication adherence (i.e. compliance) over 1 year in children and adolescents with ADHD in a routine clinical setting. COMPLY was a prospective 12-month, observational, open-label study that included children and adolescents, aged 6–17 years, with ADHD. Medication adherence (i.e. compliance) was measured using the Pediatric Compliance Self-Rating (PCSR) instrument and using items 1–4 of the Medication Adherence Rating Scale (MARS). A total of 504 patients were enrolled. At baseline, 252 patients (50.0 %) were prescribed non-stimulant (atomoxetine) medication and 247 patients (49.0 %) were prescribed psychostimulant medication. Both types of medication were prescribed concomitantly in five patients (1.0 %). After 12 months, 123 patients (48.8 %) were taking atomoxetine and 176 patients (71.3 %) were taking psychostimulants. Adherence (PCSR score ≥5) was present in both groups (atomoxetine: 67.5 %; psychostimulant: 74.2 %) throughout the observation period. MARS scores declined over time in both groups (atomoxetine: from 3.7 to 2.9; psychostimulant: from 3.6 to 3.1), indicating a deterioration in adherence. There was no statistically significant difference in terms of medication adherence between the two groups.