![]() Weightings supplied by MCS are used to adjust for attrition, maintaining a sample representative of the UK population as a whole (see Missing Data). The total number of families in the MCS was 19,244: the number responding at age 14 was 11,726. Detail on MCS design and sampling is reported extensively elsewhere. Families were eligible if they received child benefit (a universal benefit with near 100% uptake at the time). The Millennium Cohort Study (MCS) is a longitudinal UK population-representative cohort of British children born between the 1st September 2000 and the 11th January 2002. ![]() Our aims were to estimate the proportion of children with ADHD in the UK who are treated with medication, and to examine barriers to and predictors of medication use for ADHD at age 14, controlling for ADHD symptom severity at age seven. ![]() The current study explores child, parent, and sociodemographic predictors of medication use among children with ADHD in a UK population-representative cohort. However, the evidence base is limited in that studies examining what predicts medication use do not typically adjust for ADHD symptom severity, meaning factors that act as barriers to medication, but which are also associated with symptom severity are conflated in the findings. Low SES and being of ethnic minority have been reported to be a barrier to accessing medication or services. Co-occurring disorders, particularly conduct and oppositional disorders, have also been reported to be associated with increased likelihood of ADHD medication as have intellectual disability and lower cognitive ability. Įxisting evidence as to whether socio-cultural factors also operate as barriers and predictors to accessing pharmacological treatment for ADHD is mixed: some studies find no differences by gender, another reports that boys are more likely to be prescribed medication and one finds that treatment initiation (both pharmacological and psychotherapy) is more common in boys than girls in East Asia, although not in central Europe. Factors that predict service utilisation include comorbid disorders, adult perceptions of problems and willingness to engage. A recent systematic review identifies a group of “wider determinants” affecting access to care for ADHD operating at societal level including gender, age, ethnicity, socioeconomic status (SES), social networks and urban residence. Social and cultural influences impact on what treatment recommendations are made, whether children receive the most appropriate treatment and also influence parents’ attitudes. There is less knowledge of whether treatment decisions are predicted by sociodemographic or clinical characteristics. ADHD may be more often medicated in boys because clinicians may think a prototypical ADHD child is male, and perhaps conduct problems make boys more disruptive in the classroom, leading to boys being more often treated.īarriers to accessing care for attention deficit/hyperactivity disorder (ADHD) have been studied at the levels of identification and referral to specialist services where an assessment is made and diagnosis assigned. Conduct problems also predicted medication independently of ADHD symptoms. Girls with ADHD were less likely to be prescribed medication, even when they displayed similar ADHD symptom levels to boys. ![]() Our study is the first to assess predictors of medication whist adjusting for ADHD symptom severity. Male gender (AOR 3.66, 95% CI 1.75, 7.66) and conduct problems at age seven (AOR 1.24 95% CI 1.04, 1.47) and 14 predicted medication use at age 14 after adjusting for symptom severity. The median age at initiation was 9 years (range 3–14). ![]() 45.57% of children with ADHD ( N = 305) were taking medication. The weighted prevalence of ADHD was 3.97% ( N = 11,708). Logistic regression models were used to identify factors that predict medication use for ADHD (the main outcome measure), adjusting for symptom severity at age seven. Methodsĭata from the Millennium Cohort Study on child ADHD, medication use for ADHD at age 14 (in 2014–2015) and child, parent and sociodemographic variables were collated. We examined the proportion of children using medication for ADHD, age of initiation of medication, and predictors of medication use in a population-representative cohort. Little is known about sociodemographic and clinical factors that predict and act as barriers to ADHD medication independently of symptom severity. ![]()
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