Objective

Our objective was to determine whether attention-deficit/hyperactivity disorder (ADHD) medication is associated with a decreased risk of unintentional injuries in children and adolescents in the United States across sexes, age groups and injury types.

Method

We used de-identified inpatient, outpatient, and filled prescription claims data from the Truven Health MarketScan Research Databases. Individuals were followed from January 1, 2005, date of first ADHD diagnosis, or medication prescription, or age 6 years, whichever occurred last, until December 31, 2014, first healthcare insurance disenrollment, or the first year at which their age was recorded as 19 years, whichever occurred first. A person was considered on ADHD medication during a given month if a prescription was filled in that month. The outcome was defined as emergency department visits for injuries, including traumatic brain injuries, with unintentional causes. Odds of having the outcome were compared between medicated and unmedicated months at the population-level and in within-individual analyses using logistic regression.

Results

Among 1,968,146 individuals diagnosed with ADHD or receiving ADHD medication, 87,154 had at least one event. At the population level, medication use was associated with a lower risk of injuries, both in boys (odds ratio [OR] = 0.85; 95% CI = 0.84−0.86) and girls (OR = 0.87; 95% CI = 0.85−0.89). Similar results were obtained from within-individual analysis among male (OR = 0.72; 95% CI = 0.70−0.74) and female (OR = 0.72; 95% CI = 0.69−0.75) children, and among male (OR = 0.64; 95% CI = 0.60−0.67) and female (OR = 0.65; 95% CI = 0.60−0.71) adolescents. Similar results were found for traumatic brain injuries.

Conclusion

ADHD medication use was associated with a reduction of different types of unintentional injuries in children and adolescents of both sexes.

中文翻译：

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儿童和青少年注意力缺陷/多动障碍药物治疗和意外伤害。

客观的

我们的目标是确定注意力缺陷/多动障碍 (ADHD) 药物是否与美国不同性别、年龄组和伤害类型的儿童和青少年意外伤害风险降低有关。

方法

我们使用了来自 Truven Health MarketScan 研究数据库的去标识化住院、门诊和填写的处方索赔数据。从 2005 年 1 月 1 日、首次 ADHD 诊断日期或药物处方日期或 6 岁（以最后发生者为准）至 2014 年 12 月 31 日、首次退出医疗保险或他们的年龄记录为19 年，以先到者为准。如果某个人在该月填写了处方，则在该月内考虑使用 ADHD 药物。结果被定义为因意外原因造成的伤害，包括创伤性脑损伤的急诊就诊。使用逻辑回归在人群水平和个人内部分析中比较了用药和未用药月份之间获得结果的几率。

结果

在被诊断患有多动症或接受多动症药物治疗的 1,968,146 人中，87,154 人至少发生过一次事件。在人群水平上，药物使用与较低的伤害风险相关，男孩（优势比 [OR] = 0.85；95% CI = 0.84−0.86）和女孩（OR = 0.87；95% CI = 0.85−0.89） ）。从男性 (OR = 0.72; 95% CI = 0.70-0.74) 和女性 (OR = 0.72; 95% CI = 0.69-0.75) 儿童以及男性 (OR = 0.64; 95 % CI = 0.60−0.67) 和女性 (OR = 0.65; 95% CI = 0.60−0.71) 青少年。外伤性脑损伤也有类似的结果。

结论

ADHD 药物的使用与减少男女儿童和青少年不同类型的意外伤害有关。