Patient and provider characteristics related with prescribing of ADHD medication: Nationwide health insurance claims database study in Korea

Asia Pac Psychiatry. 2018 Mar;10(1). doi: 10.1111/appy.12289. Epub 2017 Jun 20.

Abstract

Background: Little is known about the association between prescribing of attention deficit hyperactivity disorder (ADHD) medication and the patient's age, gender, and type of medical institution in Asia region.

Introduction: This study investigates the prevalence and factors of diagnosis and pharmacological treatment of ADHD in the pediatric population.

Methods: Using the Korea Health Insurance database, study participants were identified as pediatric patients (≤17 years) with at least 1 diagnosis of ADHD (ICD-10, F90) from January 1, 2007 to December 31, 2011. The annual prevalence of ADHD diagnosis and medication was calculated. Annual differences in the prevalence between 2007 and 2011 with 95% confidence intervals (CIs) were estimated. We conducted multiple logistic regression analysis to estimate adjusted odds ratios (aORs) and their 95% CI to investigate predictors associated with prescribing of ADHD medication.

Results: The prevalence of ADHD medication prescribing increased by 26.57% (95% CI, 26.27-26.88) from 0.53% in 2007 to 0.72% in 2011. The prevalence increased by 41.56% (95% CI, 40.51-42.65) in females compared with 34.91% (95% CI, 34.47-35.36) in males. Whereas the prevalence decreased in patients younger than 6 years old, it increased by 74.30% (95% CI, 72.84-75.79) in the 13 to 17-year group. Males were more likely than females to be treated with ADHD medication (aOR, 1.12; 95% CI, 1.10-1.13). Physician specialty (psychiatry vs non-psychiatry) (aOR, 1.37; 95% CI, 1.34-1.40) were associated with prescribing of ADHD medication.

Conclusion: Rapid increases in the diagnosis and pharmacological treatment of ADHD in the pediatric population have been observed. While demographic characteristics were similar to other countries, provider characteristics were different with others reporting that the majority of patients were treated by physicians specializing in psychiatry.

Keywords: attention deficit hyperactivity disorder (ADHD); prevalence; trend.

MeSH terms

  • Adolescent
  • Adrenergic Uptake Inhibitors / therapeutic use*
  • Atomoxetine Hydrochloride / therapeutic use*
  • Attention Deficit Disorder with Hyperactivity / diagnosis
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Attention Deficit Disorder with Hyperactivity / epidemiology
  • Central Nervous System Stimulants / therapeutic use*
  • Child
  • Child, Preschool
  • Databases, Factual / statistics & numerical data
  • Drug Prescriptions / statistics & numerical data*
  • Female
  • Humans
  • Insurance, Health / statistics & numerical data*
  • Male
  • Methylphenidate / therapeutic use*
  • Physicians / statistics & numerical data*
  • Prevalence
  • Psychiatry / statistics & numerical data*
  • Republic of Korea / epidemiology

Substances

  • Adrenergic Uptake Inhibitors
  • Central Nervous System Stimulants
  • Methylphenidate
  • Atomoxetine Hydrochloride