141st APHA Annual Meeting and Exposition

In This section

286512
Adherence to treatment guidelines and barriers to access of health care services in children and adolescents with ADHD

Monday, November 4, 2013 : 11:00 AM - 11:10 AM

Megan Brewster , Department of Pharmacy Administration, Mylan School of Pharmacy, Duquesne University, Pittsburgh, PA
Darshini Shah, BS , Department of Pharmacy Administration, Mylan School of Pharmacy, Duquesne University, Pittsburgh, PA
Andrea Pfalzgraf, MPH, PhD , Department of Pharmacy Administration, Mylan School of Pharmacy, Duquesne University, Pittsburgh, PA
Background: Attention-Deficit/Hyperactivity Disorder(ADHD) is the most common neurobehavioral disorder in youth. Due to increasing prevalence, the American Academy of Pediatrics(AAP) released clinical recommendations for the diagnosis and treatment of ADHD in patients under the age of eighteen in 2000-2001. These recommendations were updated in 2011. The purpose of this study was to determine whether children and adolescents with ADHD are being treated in accordance with AAP recommendations, and explore the barriers to treatment. Methods: The study utilized the Centers for Disease Control's(CDC) 2009/10 National Survey of Children with Special Health Care Needs data. A retrospective analysis was conducted using SAS 9.3. Results: Reported treatments were consistent with AAP recommendations for youth aged 6-18 years old. For children ages 4-5, AAP recommends behavioral therapy as first line treatment. Approximately 53% of children ages 4-5 were receiving behavioral therapy. In the absence of significant improvement, AAP recommends the addition of methylphenidate. Of the 44% who reported taking a medication, 18,549 were taking methylphenidate, but nearly as many (15,921) were taking a different medication. Additionally, 59,773 youth ages 4-18 were taking medication not approved by the FDA to treat ADHD. The most commonly reported barriers to services included cost, lack of resources in communities and schools, and health plan problems. Conclusions: Reported treatment for ADHD was consistent with AAP recommendations for children aged 6-18, but not for children aged 4-5. There is substantial off-label drug use in the treatment of this disorder. Furthermore, barriers exist when treating children and adolescents with ADHD.

Learning Areas:
Provision of health care to the public
Public health or related laws, regulations, standards, or guidelines

Learning Objectives:
Compare reported treatment of children and adolescents with ADHD to American Academy of Pediatrics guidelines. Identify barriers to treatment for children and adolescents with ADHD.

Keywords: Children With Special Needs, Barriers to Care

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: The prevalence of off-label use in the treatment of ADHD in children and adolescents is discussed.

Qualified on the content I am responsible for because: I am currently a graduate student pursuing a Masters degree in Pharmacy Administration. I have a strong interest in public health, particularly in the area of women's and children's health. I completed this project with the guidance of my adviser who has done much of her research in the area of children's mental health, specifically major depressive disorder in children and adolescents.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.