Objective: 

The objective of this study was to examine the simultaneous impact of patient-related and parent-related factors, medication-related factors, and health care system-related factors on attention-deficit/hyperactivity disorder (ADHD) medication continuity.

Method: 

Stimulant-naïve children (N = 144, M_age = 8 yrs, 71% male) with ADHD completed a methylphenidate (MPH) trial and were followed for 1 year after trial completion and return to community care. Multivariable analysis investigated predictors of (1) having at least 1 filled ADHD prescription after return to community care versus none and (2) having more days covered with medicine after return to community care. Predictors included race; age; sex; income; baseline ADHD symptom severity; MPH trial experience; child and parent mental health conditions; and parent beliefs about ADHD, ADHD medications, and therapeutic alliance.

Results: 

One hundred twenty-one children (84%) had at least 1 filled ADHD medication prescription (mean = 178 d covered by medication) in the year after return to community care. Multivariable models found that a weaker perceived clinician-family working alliance predicted not filling any ADHD prescriptions. Among those who filled ≥1 prescription, factors linked to fewer days of ADHD medication coverage included child sociodemographic factors (non-White race, older age, being female, and lower income), lower parent beliefs that the child's ADHD affects their lives, and higher parent beliefs that medication is harmful, while child oppositional defiant disorder and parental ADHD predicted having more days of medication coverage.

Conclusion: 

Child demographic factors, parent beliefs, and medication-related factors are associated with continuation of ADHD medication. These findings may facilitate the development of effective strategies to improve ADHD medication continuity for children from diverse groups.

中文翻译：

---

注意力缺陷/多动症儿童兴奋剂药物连续性的预测因素

客观的： 

本研究的目的是检查患者相关因素和家长相关因素、药物相关因素以及医疗保健系统相关因素对注意力缺陷/多动障碍（ADHD）药物连续性的同时影响。

方法： 

患有 ADHD的未使用过兴奋剂的儿童（N = 144，中号_年龄= 8 岁，71% 为男性）完成了哌醋甲酯 (MPH) 试验，并在试验完成后随访 1 年并返回社区护理。多变量分析调查了以下预测因素：(1) 返回社区护理后至少服用 1 份多动症处方药与没有服用药物；(2) 返回社区护理后服用药物的天数更长。预测因素包括种族；年龄; 性别; 收入; 基线 ADHD 症状严重程度；MPH试用经验；儿童和家长的心理健康状况；以及家长对多动症、多动症药物和治疗联盟的看法。

结果： 

121 名儿童 (84%) 在返回社区护理后的一年内至少有 1 份 ADHD 药物处方（平均 = 药物覆盖 178 天） 。多变量模型发现，感知较弱的临床医生-家庭工作联盟预计不会提供任何多动症处方。在服用 ≥1 份处方的患者中，与多动症药物覆盖天数减少相关的因素包括儿童社会人口因素（非白人、年龄较大、女性和收入较低）、家长对孩子的多动症影响其生活的信念较低，以及较高的家长认为药物是有害的，而儿童对立违抗性障碍和父母多动症则预示着药物治疗的天数会更长。

结论： 

儿童人口统计因素、父母信念和药物相关因素与继续 ADHD 药物治疗有关。这些发现可能有助于制定有效的策略，以改善不同群体儿童的多动症药物连续性。