Factors associated with premature treatment discontinuation among thai children and adolescents with attention deficit hyperactivity disorder [ADHD]

Abstract

© 2018, Medical Association of Thailand. All rights reserved. Objective: To identify factors that contributed to premature treatment discontinuation among Thai children and adolescents with attention deficit hyperactivity disorder [ADHD]. Materials and Methods: This was a retrospective study. The parents of ADHD subjects were divided into three groups which were based on their children’s adherence to treatment: 1) early discontinuation [ED] group, 2) late discontinuation [LD] group, and 3) control group. The possible factors that might cause treatment discontinuation were collected through chart reviews and interviews (telephone or face-to-face) by trained personnel. The Chi-squared and Kruskal-Wallis tests were performed when appropriate to identify the associated factors. Multivariate logistic regression analyses (backward stepwise method) were also utilized. Results: A total of 375 parents of ADHD patients were recruited. The parents were separated into 3 groups where 195 parents were in the control group, while 105 and 75 were in the ED and LD groups, respectively. Multiple logistic regression analyses revealed that factors associated with treatment discontinuation were increased age (adj. OR = 1.19), family income > 50,000 baht/month (adj. OR = 2.48), parents’ knowledge of “Treatment of ADHD is unnecessary.” (adj. OR = 1.37) and “Medication for ADHD is an essential intervention for ADHD” (adj. OR = 0.61). The reasons for treatment discontinuation between ED and LD revealed that patients in the LD group experience more “intolerable side effects” (38.7% vs. 22.9%) and less “improved or cured children” (16.0% vs. 29.5) compared to those in the ED group. Conclusion: The significant factors that predicted premature treatment discontinuation among Thai children and adolescents with ADHD were the age of the patients, family income, parents’ lack of knowledge of ADHD, and negative parental attitudes toward the pharmacological management of ADHD.