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. 2016 Sep;82(3):858-68.
doi: 10.1111/bcp.13000. Epub 2016 Jun 9.

Prescribing trends of attention-deficit hyperactivity disorder (ADHD) medications in UK primary care, 1995-2015

Christel Renoux  1   2   3 , Ju-Young Shin  1 , Sophie Dell'Aniello  1 , Emma Fergusson  4 , Samy Suissa  1   3
Affiliations

Prescribing trends of attention-deficit hyperactivity disorder (ADHD) medications in UK primary care, 1995-2015

Christel Renoux et al. Br J Clin Pharmacol. 2016 Sep.

Abstract

Aim: The aim of the present study was to describe the prescription of medications for attention-deficit hyperactivity disorder (ADHD) in the UK between 1995 and 2015.

Methods: Using the Clinical Practice Research Datalink (CPRD), we defined a cohort of all patients aged 6-45 years, registered with a general practitioner between January 1995 and September 2015. All prescriptions of methylphenidate, dexamphetamine/lisdexamphetamine and atomoxetine were identified and annual prescription rates of ADHD were estimated using Poisson regression.

Results: Within a cohort of 7 432 735 patients, we identified 698 148 prescriptions of ADHD medications during 41 171 528 person-years of follow-up. Usage was relatively low until 2000, during which the prescription rate was 42.7 [95% confidence interval (CI) 20.9, 87.2] prescriptions per 10 000 persons, increasing to 394.4 (95% CI 296.7, 524.2) in 2015, corresponding to an almost 800% increase (rate ratio 8.87; 95% CI 7.10, 11.09). The increase was seen in all age groups and in both sexes but was steepest in boys aged 10-14 years. The prescription rate in males was almost five times that of females. Methylphenidate remained the most prescribed drug during the 20-year study period, representing 88.9% of all prescriptions in the 6-24-year-old group, and 63.5% of all prescriptions in adults (25-45 years of age).

Conclusions: Prescription rates of ADHD medications have increased dramatically in the past two decades. This may be due, at least in part, to both an increase in the number of patients diagnosed with ADHD over time and a higher percentage of those patients treated with medication.

Keywords: CPRD; UK; attention-deficit hyperactivity disorder; methylphenidate; time trends.

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Figures

Figure 1
Figure 1
Attention‐deficit hyperactivity disorder prescription rates in the UK Clinical Practice Research Datalink, 1995–2015, overall and stratified by sex. formula image, Boys/Men; formula image, Girls/Women; formula image, Overall
Figure 2
Figure 2
Attention‐deficit hyperactivity disorder prescription rates in the UK Clinical Practice Research Datalink, 1995–2015, stratified by age group, among boys/men (A) and girls/women (B). formula image, 6–9; formula image, 10–14; formula image, 15–18; formula image, 19–24; formula image, 25–45
Figure 3
Figure 3
Attention‐deficit hyperactivity disorder prescription rates in the UK Clinical Practice Research Datalink, 1995–2015, stratified by drugs. formula image, Methylphenidate; formula image, Atomoxetine; formula image, Dexamfetamine
Figure 4
Figure 4
Number of patients starting an attention‐deficit hyperactivity disorder (ADHD) medication per 100 000 persons per year in the UK Clinical Practice Research Datalink, 1995–2015, among boys/men (A) and girls/women (B). formula image, 6–9; formula image, 10–14; formula image, 15–18; formula image, 19–24; formula image, 25–45
Figure 5
Figure 5
Number of patients with a first attention‐deficit hyperactivity disorder (ADHD) diagnosis per 100 000 persons per year in the UK Clinical Practice Research Datalink, 1995–2015, among boys/men (A) and girls/women (B). formula image, 6–9; formula image, 10–14; formula image, 15–18; formula image, 19–24; formula image, 25–45
Figure 6
Figure 6
Number of patients with an attention‐deficit hyperactivity disorder prescription within 1 year of diagnosis in the UK Clinical Practice Research Datalink, 1995–2014. formula image, Treated; formula image, Untreated
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