persistence of pharmacological treatment into adulthood, in uk primary care, for adhd patients who started treatment in childhood or adolescence持久性的药理治疗到成年,在英国初级保健,治疗多动症患者在儿童或青少年时期开始治疗.pdfVIP

McCarthy et al. BMC Psychiatry 2012, 12:219 /1471-244X/12/219 RESEARCH ARTICLE Open Access Persistence of pharmacological treatment into adulthood, in UK primary care, for ADHD patients who started treatment in childhood or adolescence Suzanne McCarthy1,2*†, Lynda Wilton3†, Macey L Murray3†, Paul Hodgkins4†, Philip Asherson5† and Ian CK Wong3,6† Abstract Background: ADHD guidelines in the UK suggest that children and adults who respond to pharmacological treatment should continue for as long as remains clinically effective, subject to regular review. To what extent patients persist with treatment from childhood and adolescence into adulthood is not clear. This study aims to describe, in UK primary care, the persistence of pharmacological treatment for patients with ADHD who started treatment aged 6– 17 years and to estimate the percentage of patients who continued treatment from childhood and adolescence into adulthood. Methods: The Health Improvement Network (THIN) database was used to identify patients with ADHD who received their first prescription for methylphenidate/ dexamfetamine/atomoxetine, aged 6– 17 years. Patients were monitored until their ‘censored date’ (the earliest of the following dates: date the last prescription coded in the database ended, end of the study period (31st December 2008), date at which they transferred out of their practice, date of death, the last date the practice contributed data to the database). Persistence of treatment into adulthood was estimated using Kaplan Meier analysis. Results: 610 patients had follow-up data into adulthood. 213 patients (93.4% male) started treatment between 6– 12 years; median treatment duration 5.9 years. 131 (61.5%) stopped before 18 years, 82 (38.5%) were still on treatment age ≥18 years. 397 patients (86.4% male) started treatment between 13–