Published October 2019 | The Journal of Pediatrics

Attention deficit hyperactivity disorder (ADHD) affects eight to 12% of school-aged children in the US, making it the most common neurodevelopmental disorder in childhood. Current guidelines recommend behavioral therapies and/or stimulant medication, yet as few as half of children diagnosed with ADHD receive medication. While many have speculated about which factors influence the likelihood of mediation prescription, a retrospective cohort study of 577 children presenting for ADHD at 50 community-based practices took a more comprehensive look.

“Pediatricians are less likely to prescribe ADHD medications to children with certain sociodemographic characteristics and ADHD symptom profiles,” explains lead researcher, Kelly Kamimura-Nishimura, MD, MS, Division of Developmental and Behavioral Pediatrics.

The study evaluated 31 possible predictors of medication prescription, including several factors highlighted in previous studies such as male sex, white race, younger latency age, severity of symptoms, urban residence of the patient, as well as age of provider. This study also explored the roles of income, health insurance, and other comorbidities.

Even after correcting for higher rates of male ADHD diagnosis, boys were still more likely to receive medication. Higher inattention scores and living in a neighborhood with higher medical expenditures also increased the likelihood of medication prescription. However—contrary to the researchers’ initial hypothesis—factors such as the child’s race or physician characteristics did not relate to frequency of medication prescription.

Researchers used the geographic information system Alteryx Designer to retrieve and map out the sociodemographic data. Findings have since been presented at the American Academy of Child and Adolescent Psychiatry annual meeting. A crucial next step for the research will be developing strategies to “minimize barriers to receiving evidence-based treatment for children with ADHD from diverse populations,” Kamimura-Nishimura says.

Multivariable Regression Results Predicting Whether Children were Prescribed ADHD Medication