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Patterns of long-term ADHD medication use in Australian children
  1. Daryl Efron1,2,
  2. Melissa Mulraney3,4,
  3. Emma Sciberras1,5,
  4. Harriet Hiscock1,6,
  5. Stephen Hearps7,
  6. David Coghill4,8
  1. 1 Health Services, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
  2. 2 General Medicine, The Royal Children's Hospital, Melbourne, Victoria, Australia
  3. 3 Health Services, Murdoch Children's Research Institute, Parkville, Victoria, Australia
  4. 4 Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
  5. 5 Psychology, Deakin University, Burwood, Victoria, Australia
  6. 6 Centre for Community Child Health, Royal Children's Hospital, Melbourne, Victoria, Australia
  7. 7 Child Neuropsychology, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
  8. 8 Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Parkville, Victoria, Australia
  1. Correspondence to Dr Daryl Efron, Health Services, Murdoch Childrens Research Institute, Melbourne, VIC 3052, Australia; daryl.efron{at}


Objective Adherence to attention-deficit/hyperactivity disorder (ADHD) medication treatment is often suboptimal. This can compromise patient outcomes. We aimed to describe the patterns of ADHD medication use in Australian children, and characteristics associated with patterns of use.

Design Dispensing data were analysed for all redeemed prescriptions of methylphenidate, dexamphetamine and atomoxetine between May 2002 and March 2015 from waves 1 to 6 of the Longitudinal Study of Australian Children (n=4634, age 4–5 years at wave 1). Medication coverage was defined as the proportion of time between the first and the last redeemed prescriptions in which the child was taking medication. Associations between predictor variables (child sex, ADHD symptom severity, age at first prescription, family socioeconomic status (SES), single parent status, parent education and parent mental health) and medication coverage were examined using regression analyses.

Results 166 (3.6%) children had ever redeemed a prescription for an ADHD medication. Boys had higher odds of having taken ADHD medication than girls (OR=3.9; 95% CI 2.7 to 5.7). The mean medication coverage was 59.8%. Medication coverage was lower in children from families of lower SES (β=4.0; 95% CI 0.2 to 7.8, p=0.04). Medication coverage was relatively high in the first year of prescription, then decreased progressively, only increasing again after 5 or 6 years of treatment.

Conclusions Children with ADHD from socially disadvantaged families were less likely to receive medication consistently. Prescribers need to continue to support families over many years to ensure medication is used consistently for children with ADHD.

  • attention-deficit/hyperactivity disorder
  • medication
  • adherence

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  • Funding DE is funded by a Clinician Scientist Fellowship from MCRI. ES is funded by an NHMRC Career Development Fellowship 1110688 (2016-21) and a veski Inspiring Women’s Fellowship. HH is supported by a National Health and Medical Research Council (NHMRC) Practitioner Fellowship (1136222). The MCRI is supported by the Victorian Government’s Operational Infrastructure Support Program.

  • Competing interests DC reports grants and personal fees from Shire, personal fees from Eli Lilly, personal fees from Medice, personal fees from Novartis, personal fees from Oxford University Press, grants from Vifor, personal fees from Servier.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by the Australian Institute of Family Studies Ethics Committee (approval number 1304).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request.