Prescribing for young people with Attention Deficit Hyperactivity Disorder in UK primary care: analysis of data from the Clinical Practice Research Datalink

Abstract

Background Guidance on management of Attention Deficit Hyperactivity Disorder [ADHD] in the UK was issued by the National Institute for Clinical Excellence [NICE] in 2008. No UK study has examined all psychotropic prescribing in young people with ADHD since the introduction of the guidance; this is especially relevant due to the high prevalence of psychiatric comorbidity in this population. Aim To describe primary care prescribing of ADHD and other psychotropic medication for young people with ADHD. Design and setting Analysis of records of patients with an ADHD diagnosis in the UK Clinical Practice Research Datalink from 2005 to 2013. Methods Estimation of the prevalence of prescribing of ADHD and other psychotropic medication over 8 years follow-up for cases aged 10 to 20 years in 2005. Results Of 9,390 ADHD cases, 61.6% (95% confidence interval (CI) = 60.6% to 62.5%) had a prescription at some point for ADHD medication. Prescribing of other psychotropic medication was higher in girls than boys (36.4% versus 22.7%; p<0.001). ADHD prescribing prevalence declined steeply between the ages of 16 and 18 from 37.8% (95% CI 36.6 to 38.9) to 23.7% (95% CI: 22.7 to 24.6%). There was a parallel increase in prescribing of other psychotropics from 3.8% (95% CI: 3.4% to 4.3%) to 6.6% (95% CI 6.0 to 7.3%). Conclusion There is scope to optimise the management of ADHD and psychiatric comorbidities in young people, and a need for sustainable models of ADHD care for young adults, supported by appropriate training and specialist services.