Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Mar-Apr;12(2):110-6.
doi: 10.1016/j.acap.2012.01.003. Epub 2012 Feb 10.

Trends in attention deficit hyperactivity disorder ambulatory diagnosis and medical treatment in the United States, 2000-2010

Craig F Garfield  1 , E Ray Dorsey, Shu Zhu, Haiden A Huskamp, Rena Conti, Stacie B Dusetzina, Ashley Higashi, James M Perrin, Rachel Kornfield, G Caleb Alexander
Affiliations

Trends in attention deficit hyperactivity disorder ambulatory diagnosis and medical treatment in the United States, 2000-2010

Craig F Garfield et al. Acad Pediatr. 2012 Mar-Apr.

Abstract

Objectives: Because of several recent clinical and regulatory changes regarding attention deficit-hyperactivity disorder (ADHD) in the United States, we quantified changes in the diagnosis of ADHD and its pharmacologic treatment from 2000 through 2010.

Methods: We used the IMS Health National Disease and Therapeutic Index, a nationally representative audit of office-based providers, to examine aggregate trends among children and adolescents younger than 18 years of age. We also quantified how diagnosis and treatment patterns have evolved on the basis of patient and physician characteristics and the therapeutic classes used.

Results: From 2000 to 2010, the number of physician outpatient visits in which ADHD was diagnosed increased 66% from 6.2 million (95% confidence interval 5.5-6.9M) to 10.4 million visits (95% confidence interval 9.3-11.6 million). Of these visits, psychostimulants have remained the dominant treatment; they were used in 96% of treatment visits in 2000 and 87% of treatment visits in 2010. Atomoxetine use decreased from 15% of treatment visits upon product launch in 2003 to 6% of treatment visits by 2010. The use of potential substitute therapies-clonidine, guanfacine, and bupropion-remained relatively constant (between 5% and 9% of treatment visits) during most of the period examined. During this period, the management of ADHD shifted away from pediatricians and towards psychiatrists (from 24% to 36% of all visits) without large changes in illness severity or the proportion of ADHD treatment visits accounted for by males (73%-77%).

Conclusions: In 10 years, the ambulatory diagnosis of ADHD increased by two-thirds and is increasingly managed by psychiatrists. The effects of these changing treatment patterns on children's health outcomes and their families are unknown.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
U.S. TRENDS IN USE OF PHARMACOTHERAPIES TO TREAT ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD), 2000-2010. Source: IMS Health National Disease and Therapeutic Index™, 2000-2010
FIGURE 2
FIGURE 2
U.S. TRENDS IN OFFICE-BASED DIAGNOSIS AND MEDICAL TREATMENT OF ADHD, 2000-2010.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Centers for Disease Control and Prevention Increasing prevalence of parent-reported attention deficit/hyperactivity disorder among children: United States, 2003 and 2007. MMWR Morb Mortal Wkly Rep 2010. 59:1439–1443. - PubMed
    1. Pelham WE, Foster ME, Robb JA. The economic impact of attention-deficit/hyperactivity disorder in children and adolescents. Ambul. Pediatr. 2007;7:121–131. - PubMed
    1. Barkley RA. Major life activity and health outcomes associated with attention-deficit/hyperactivity disorder. J Clin Psychiatry. 2002;63(Suppl 12):10–15. - PubMed
    1. Mannuzza S, Klein RG. Long-term prognosis in attention-deficit/hyperactivity disorder. Child Adolesc Psychiatr Clin N Am. 2000;9:711–726. - PubMed
    1. Clinical Practice Guideline Diagnosis and Evaluation of the Child With Attention-Deficit/Hyperactivity Disorder. American Academy of Pediatrics. Pediatrics. 2000;5:1158–70. - PubMed

Publication types