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Adherence, persistence, and medication discontinuation in patients with attention-deficit/hyperactivity disorder – a systematic literature review

Overview of attention for article published in Neuropsychiatric Disease and Treatment, August 2014
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • Among the highest-scoring outputs from this source (#21 of 2,534)
  • High Attention Score compared to outputs of the same age (98th percentile)
  • High Attention Score compared to outputs of the same age and source (89th percentile)

Mentioned by

news
12 news outlets
twitter
2 tweeters

Citations

dimensions_citation
101 Dimensions

Readers on

mendeley
156 Mendeley
Title
Adherence, persistence, and medication discontinuation in patients with attention-deficit/hyperactivity disorder – a systematic literature review
Published in
Neuropsychiatric Disease and Treatment, August 2014
DOI 10.2147/ndt.s65721
Pubmed ID
Authors

Vanja Sikirica, Mei Lu, Peter Greven, Yichen Zhong, Paige Qin, Jipan Xie, Kavita Gajria

Abstract

Untreated attention-deficit/hyperactivity disorder (ADHD) can lead to substantial adverse social, economic, and emotional outcomes for patients. The effectiveness of current pharmacologic treatments is often reduced, due to low treatment adherence and medication discontinuation. This current systematic literature review analyzes the current state of knowledge surrounding ADHD medication discontinuation, focusing on: 1) the extent of patient persistence; 2) adherence; and 3) the underlying reasons for patients' treatment discontinuation and how discontinuation rates and reasons vary across patient subgroups. We selected 91 original studies (67 with persistence/discontinuation results, 26 with adherence results, and 41 with reasons for discontinuation, switching, or nonadherence) and 36 expert opinion reviews on ADHD medication discontinuation, published from 1990 to 2013. Treatment persistence on stimulants, measured by treatment duration during the 12-month follow-up periods, averaged 136 days for children and adolescents and 230 days for adults. Owing to substantial study heterogeneity, comparisons across age or medication type subgroups were generally inconclusive; however, long-acting formulations and amphetamines were associated with longer treatment duration than short-acting formulations and methylphenidates. The medication possession ratio, used to measure adherence, was <0.7 for all age groups and medication classes during a 12-month period. Adverse effects were the most commonly cited reason for discontinuation in all studies. Original research studies reported the lack of symptom control as a common discontinuation reason, followed by dosing inconvenience, social stigma associated with ADHD medication, and the patient's attitude. In summary, although there was a lack of consistency in the measurement of adherence and persistence, these findings indicate that drug adherence and persistence are generally poor among patients with ADHD. Clinicians may be able to help improve adherence and persistence to ADHD treatment by educating caregivers and patients on treatment goals, administering long-acting medications, and following-up with patients to verify if medication is still effective and well-tolerated.

Twitter Demographics

The data shown below were collected from the profiles of 2 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 156 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 3 2%
Netherlands 1 <1%
Germany 1 <1%
Spain 1 <1%
Portugal 1 <1%
Unknown 149 96%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 24 15%
Student > Master 23 15%
Researcher 22 14%
Other 14 9%
Student > Bachelor 14 9%
Other 45 29%
Unknown 14 9%
Readers by discipline Count As %
Medicine and Dentistry 51 33%
Psychology 29 19%
Social Sciences 9 6%
Pharmacology, Toxicology and Pharmaceutical Science 9 6%
Neuroscience 8 5%
Other 26 17%
Unknown 24 15%

Attention Score in Context

This research output has an Altmetric Attention Score of 85. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 24 January 2020.
All research outputs
#248,006
of 15,488,719 outputs
Outputs from Neuropsychiatric Disease and Treatment
#21
of 2,534 outputs
Outputs of similar age
#3,702
of 211,183 outputs
Outputs of similar age from Neuropsychiatric Disease and Treatment
#2
of 19 outputs
Altmetric has tracked 15,488,719 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 98th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,534 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.8. This one has done particularly well, scoring higher than 99% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 211,183 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 98% of its contemporaries.
We're also able to compare this research output to 19 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 89% of its contemporaries.