Predictors of Stimulant Medication Continuity in Children with ADHD

Grant #: 3R01MH105425-04S1 (Diversity Supplement)
PI: Kelly Kamimura-Nishimura, MD, MS
Mentors: Tanya Froehlich, MD, Jeff Epstein, PhD
Co-I: Bill Brinkman, MD, MEd, MSc; Avani Modi, PhD; Andy Beck, MD, MPH

Despite abundant evidence of attention-deficit/hyperactivity disorder (ADHD) medication benefits, most children with ADHD have poor continuity of treatment. Non-adherence to ADHD medication regimens has been linked to a number of factors, but limited information is available about the roles played by child comorbid conditions, caregiver mental health diagnoses, and social/financial hardships. To address this gap in the literature, this project will examine predictors of stimulant treatment continuity in the community setting: participants’ medication fill records (n=168) will be examined for the 12-month period following completion of a methylphenidate randomized controlled trial (TEAM Study) and assumption of treatment by community providers. The project will test the hypotheses that child comorbid conditions (e.g., oppositional defiant disorder), caregiver mental health disorders (e.g., ADHD, depression), and family hardships (e.g., financial strain) are associated with decreased continuity of ADHD medication treatment. This proposal will make a substantial contribution to the current knowledge base, as there is a paucity of studies investigating child comorbid conditions and caregiver mental health factors as predictors of ADHD medication continuity, and no prior studies have addressed the role of hardships in stimulant medication continuity. Furthermore, no previous studies have investigated the simultaneous impact of these factors on ADHD medication continuity. Ultimately, our results may help to guide the development of tailored, multi-pronged interventions to improve ADHD medication adherence.