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Cited by 95Attention Deficit Hyperactivity DisorderPharmaceutical studies and practicesMental Health Treatment and Access

Attention-deficit/hyperactivity disorder medication consumption in 64 countries and regions from 2015 to 2019: a longitudinal study

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Chan, Adrienne Y.L., Ma, Tian-Tian, Lau, Wallis C.Y., Ip, Patrick, Coghill, David, Gao, Le, Jani, Yogini H., Hsia, Yingfen +7 more·2023·eClinicalMedicine
DOI 10.1016/j.eclinm.2022.101780PMC PMC10166776
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Abstract

Background: Timely recognition and appropriate treatment of attention-deficit/hyperactivity disorder (ADHD) are essential to enhance long-term outcomes of individuals with ADHD. This study aimed to evaluate the multinational trends and patterns of ADHD medication consumption. Methods: In this longitudinal trend study, we used pharmaceutical sales data of ADHD medication from the IQVIA-Multinational Integrated Data Analysis System between 2015 and 2019, covering 64 countries across the world. Consumption rates of ADHD medication were expressed as defined daily dose per 1000 child and adolescent inhabitants (aged 5-19) per day (DDD/TID). Linear mixed models were used to estimate the multinational, regional, and income level trend changes. Findings: The results showed that multinational ADHD medication consumption increased by +9.72% (95% confidence interval [CI], +6.25%, +13.31%) per year, from 1.19 DDD/TID in 2015 to 1.43 DDD/TID in 2019 across the 64 countries with marked differences between geographical locations. When stratified by countries' income levels, increases in ADHD medication consumption were observed in high-income countries but not in middle-income countries. In 2019, the pooled consumption rates of ADHD medication were 6.39 DDD/TID (95% CI, 4.63, 8.84) in high-income countries, 0.37 DDD/TID (95% CI, 0.23, 0.58) in upper-middle-income countries and 0.02 DDD/TID (95% CI, 0.01, 0.05) in lower-middle-income countries. Interpretation: Current ADHD prevalence estimates and rates of ADHD medication consumption in most middle-income countries are lower than the global epidemiological prevalence. It is therefore imperative to evaluate the potential barriers to diagnosis and treatment in these countries to minimise the risk of negative outcomes from undiagnosed and untreated ADHD. Funding: This project was funded by a grant from the Hong Kong Research Grants Council Collaborative Research Fund (project number C7009-19G).

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  • Sweden has a universal, publicly funded health-care system and has some of the highest rates of prescription of ADHD medication globally.

    “The generalisability of findings to countries with different health systems and access should be investigated because Sweden has a universal, publicly funded health-care system and has some of the highest rates of prescription of ADHD medication globally.22”

    From Evaluating ADHD medication trial representativeness: a Swedish population-based study comparing hypothetically trial-eligible and trial-ineligible individuals (2025) · cites this paper as [22]

    The Results table reports high ADHD-medication consumption in Sweden (71.72 in 2015 and 99.27 in 2019), supporting the claim that it is among the higher-consuming countries studied. The paper measures consumption rather than prescription rates, and its Discussion says it did not investigate healthcare-system differences; our copy does not establish that Sweden’s system is universal and publicly funded. No page number is available for these passages. (LLM, conf=0.86)

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Research works printed but not linked: 19

  1. [5]Wong I.C.K. Banaschewski T. Buitelaar J. Emerging challenges in pharmacotherapy research on attention-deficit hyperactivity disorder-outcome measures beyond symptom control and clinical trials Lancet Psychiatry 6 6 2019 528 537 31122482
  2. [7]National Institute for Health and Care Excellence Attention deficit hyperactivity disorder: diagnosis and management https://www.nice.org.uk/guidance/ng87 2018 29634174
  3. [8]Bolea-Alamanac B. Nutt D.J. Adamou M. Evidence-based guidelines for the pharmacological management of attention deficit hyperactivity disorder: update on recommendations from the British Association for Psychopharmacology J Psychopharmacol 28 3 2014 179 203 24526134
  4. [10]Raman S.R. Man K.K.C. Bahmanyar S. Trends in attention-deficit hyperactivity disorder medication use: a retrospective observational study using population-based databases Lancet Psychiatry 5 10 2018 824 835 30220514
  5. [12]Cruz M.P. Guanfacine extended-release tablets (intuniv), a nonstimulant selective alpha(2A)-adrenergic receptor agonist for attention-deficit/hyperactivity disorder P T 35 8 2010 448 451 20844694 PMC2935643
  6. [13]Ming X. Mulvey M. Mohanty S. Patel V. Safety and efficacy of clonidine and clonidine extended-release in the treatment of children and adolescents with attention deficit and hyperactivity disorders Adolesc Health Med Ther 2 2011 105 112 24600280 PMC3926778
  7. [14]Van Boeckel T.P. Gandra S. Ashok A. Global antibiotic consumption 2000 to 2010: an analysis of national pharmaceutical sales data Lancet Infect Dis 14 8 2014 742 750 25022435
  8. [16]Cook M.N. Estimating national drug consumption using data at different points in the pharmaceutical supply chain Pharmacoepidemiol Drug Saf 15 10 2006 754 757 16989003
  9. [18]Hsia Y. Sharland M. Jackson C. Wong I.C.K. Magrini N. Bielicki J.A. Consumption of oral antibiotic formulations for young children according to the WHO Access, Watch, Reserve (AWaRe) antibiotic groups: an analysis of sales data from 70 middle-income and high-income countries Lancet Infect Dis 19 1 2019 67 75 30522834
  10. [19]Ju C. Wei L. Man K.K.C. Global, regional, and national trends in opioid analgesic consumption from 2015 to 2019: a longitudinal study Lancet Pub Health 7 4 2022 e335 e346 35366408
  11. [27]Yan V.K.C. Blais J.E. Li X. Trends in cardiovascular medicine use in 65 middle- and high-income countries J Am Coll Cardiol 77 7 2021 1021 1023 33602460
  12. [28]Blais J.E. Wei Y. Yap K.K.W. Trends in lipid-modifying agent use in 83 countries Atherosclerosis 328 2021 44 51 34091069
  13. [30]Pereira Ribeiro J. Lunde C. Gluud C. Simonsen E. Storebo O.J. Methylphenidate denied access to the WHO list of essential medicines for the second time BMJ Evid Based Med 2022 10.1136/bmjebm-2021-111862 Epub ahead of print. 35184036 · DOI
  14. [31]Wirtz V.J. Hogerzeil H.V. Gray A.L. Essential medicines for universal health coverage Lancet 389 10067 2017 403 476 27832874 PMC7159295
  15. [32]Childress A. Hoo-Cardiel A. Lang P. Evaluation of the current data on guanfacine extended release for the treatment of ADHD in children and adolescents Expert Opin Pharmacother 21 4 2020 417 426 31971448
  16. [33]Elbe D. Switching from clonidine immediate-release to guanfacine extended-release J Can Acad Child Adolesc Psychiatry 29 2 2020 121 123 32405313 PMC7213916
  17. [34]Siffel C. Page M. Maxwell T. Patterns of lisdexamfetamine dimesylate use in children, adolescents, and adults with attention-deficit/hyperactivity disorder in Europe J Child Adolesc Psychopharmacol 30 7 2020 439 447 32315539 PMC7475084
  18. [35]Moran L.V. Ongur D. Hsu J. Castro V.M. Perlis R.H. Schneeweiss S. Psychosis with methylphenidate or amphetamine in patients with ADHD N Engl J Med 380 12 2019 1128 1138 30893533 PMC6543546
  19. [36]Grimmsmann T. Himmel W. The 10-year trend in drug prescriptions for attention-deficit/hyperactivity disorder (ADHD) in Germany Eur J Clin Pharmacol 77 1 2021 107 115 32803292 PMC7782395

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Authors
Chan, A. Y. L., Ma, T.-T., Lau, W. C. Y., Ip, P., Coghill, D., Gao, L., Jani, Y. H., Hsia, Y., Wei, L., Taxis, K., Simonoff, E., Taylor, D., Lum, T. Y., Man, K. K. C., & Wong, I. C. K.
Affiliations
  • University of Groningen (NL)
  • National Health Service (GB)
  • Hong Kong Children's Hospital (HK)
  • The University of Melbourne (AU)
  • University of Hong Kong (HK)
  • Queen's University Belfast (GB)
  • King's College London (GB)
Corresponding author
  • Man, Kenneth K.C.
  • Wong, Ian C.K.
ORCID
Venue
eClinicalMedicine
Publisher
Elsevier BV
Published
2023-04
Volume
58
Pages
101780
ISSN
2589-5370 (ISSN-L)
DOI
10.1016/j.eclinm.2022.101780
PMC
PMC10166776
OpenAlex
W4327923054
Cited by
95
References
10
Citations by year
2026: 42 · 2025: 30 · 2024: 16 · 2023: 7
FWCI
19.35
Type
journal article
Language
en
Open access
Licence
Locations
  • EClinicalMedicine (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • Research Portal (Queen's University Belfast) (publishedVersion, cc-by-nc-nd)
  • St George's Online Research Archive (St George's University of London) (acceptedVersion)
  • UCL Discovery (University College London) (submittedVersion, cc-by-nc-nd)
  • The HKU Scholars Hub (University of Hong Kong) (submittedVersion, cc-by-nc-nd)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by-nc-nd)
Funders
University Grants Committee Research Grants Council (C7009-19G)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmaceutical studies and practices
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
attention deficit hyperactivity disorder, drug sales, defined daily doses, children and adolescents, global trends, ADHD prevalence, middle-income countries

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