New York, NY—With so much focus on supply issues for ADHD, pharmacists might be surprised to learn that many children who need them have not been prescribed stimulants or other treatments for the condition.

“Characterizing the extent and pattern of unmet needs for treatment of children with attention-deficit/hyperactivity disorder (ADHD) could help target efforts to improve access to ADHD medications and outpatient mental health care,” according to a new study in the Journal of the American Medical Association Network Open.

Last fall, the FDA warned of an Adderall shortage. Within recent weeks, six pharmaceutical companies that manufacture the drug and its generics reported that some immediate-release formulations were either unavailable or hard to obtain.

Columbia University–led researchers sought to describe current ADHD medication use and lifetime outpatient mental healthcare among a large national sample of children with the condition. To do that, the study team used cross-sectional survey data from the first wave of the Adolescent Brain and Cognitive Development Study. That study was conducted from June 1, 2016, to October 15, 2018, among 1,206 children aged 9 and 10 years who met parent-reported Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) criteria for current ADHD. Statistical analysis was performed from March 23, 2022, to March 10, 2023.

The focus was on current ADHD medications, including stimulants and nonstimulants, lifetime outpatient mental healthcare, or either treatment.

The researchers found that, using a sample of 11,723 children, 1,206 had parent-reported ADHD. Those were 68.2% boys, with an average age of 9 to 10 years. Of the 759 white, non-Hispanic children [62.2%]), 149 (12.9%) were currently receiving ADHD medications.

“Children receiving ADHD medications included a significantly higher percentage of boys (15.7% [121 of 826]) than girls (7.0% [28 of 108]), white children (14.8% [104 of 759]) than black children (9.4% [22 of 206]), children of parents without a high school education (32.2% [9 of 36]) than of parents with a Bachelor’s degree or higher (11.5% [84 of 715]), and children with the combined subtype of ADHD (17.0% [83 of 505]) than with the inattentive subtype (9.5% [49 of 523]),” the authors reported.

The authors added that only about 26.2% of children (301 of 1,206) with parent-reported ADHD had ever received outpatient mental healthcare. “Children receiving outpatient mental healthcare included a significantly higher percentage of children whose parents had a high school education (36.2% [29 of 90]) or some college (31.0% [109 of 364]) than a Bachelor’s degree or higher (21.3% [153 of 715]), children with family incomes of less than $25,000 (36.5% [66 of 176]) or $25,000 to $49,999 (27.7% [47 of 174]) than $75,000 or more (20.1% [125 of 599]), and children with the combined subtype of ADHD (33.6% [166 of 505]) than with the predominantly inattentive subtype (20.0% [101 of 523]) or the hyperactive-impulsive subtype (22.4% [34 of 178]) of ADHD.”

The researchers concluded that most children with parent-reported ADHD were not receiving ADHD medications and had never received outpatient mental healthcare. “Gaps in treatment, which were not directly associated with socioeconomic disadvantage, underscore the challenges of improving communication and access to outpatient mental health care for children with ADHD,” the researchers emphasized. The problem is especially severe for girls, they added.

The content contained in this article is for informational purposes only. The content is not intended to be a substitute for professional advice. Reliance on any information provided in this article is solely at your own risk.

 « Click here to return to Weekly News.