Assessing undertreatment and overtreatment/misuse of ADHD medications in children and adolescents across continents: A systematic review and meta-analysis
Assessing undertreatment and overtreatment/misuse of ADHD medications in children and adolescents across continents: A systematic review and meta-analysis
A controversy exists on whether there is an over or underuse of medications for Attention-Deficit/Hyperactivity Disorder (ADHD). We conducted the first meta-analysis to estimate the rate of ADHD pharmacological treatment in both diagnosed and undiagnosed individuals. Based on a pre-registered protocol (CRD42018085233), we searched a broad set of electronic databases and grey literature. After screening 25,676 abstracts, we retained 36 studies including 104,305 subjects, from which 18 studies met our main analysis criteria. The pooled pharmacological treatment rates were 19.1 % and 0.9 % in school-age children/adolescents with and without ADHD, respectively. We estimated that for each individual using medication without a formal ADHD diagnosis, there are three patients with a formal diagnosis who might benefit from medication but do not receive it in the US. Our results indicate both overtreatment/misuse of medication in individuals without ADHD and pharmacological undertreatment in youths with the disorder. Our findings reinforce the need for public health policies improving education on ADHD and discussions on the benefits and limitations of ADHD medications.
ADHD, Pharmacological interventions, Prevalence, Stimulants, Treatment
64-73
Massuti, Rafael
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Moreira-maia, Carlos Renato
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Campani, Fausto
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Sônego, Márcio
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Amaro, Julia
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Akutagava-martins, Gláucia Chiyoko
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Tessari, Luca
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Polanczyk, Guilherme V.
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Cortese, Samuele
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Rohde, Luis Augusto
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1 September 2021
Massuti, Rafael
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Moreira-maia, Carlos Renato
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Campani, Fausto
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Sônego, Márcio
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Amaro, Julia
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Akutagava-martins, Gláucia Chiyoko
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Tessari, Luca
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Polanczyk, Guilherme V.
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Cortese, Samuele
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Rohde, Luis Augusto
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Massuti, Rafael, Moreira-maia, Carlos Renato, Campani, Fausto, Sônego, Márcio, Amaro, Julia, Akutagava-martins, Gláucia Chiyoko, Tessari, Luca, Polanczyk, Guilherme V., Cortese, Samuele and Rohde, Luis Augusto
(2021)
Assessing undertreatment and overtreatment/misuse of ADHD medications in children and adolescents across continents: A systematic review and meta-analysis.
Neuroscience & Biobehavioral Reviews, 128, .
(doi:10.1016/j.neubiorev.2021.06.001).
Abstract
A controversy exists on whether there is an over or underuse of medications for Attention-Deficit/Hyperactivity Disorder (ADHD). We conducted the first meta-analysis to estimate the rate of ADHD pharmacological treatment in both diagnosed and undiagnosed individuals. Based on a pre-registered protocol (CRD42018085233), we searched a broad set of electronic databases and grey literature. After screening 25,676 abstracts, we retained 36 studies including 104,305 subjects, from which 18 studies met our main analysis criteria. The pooled pharmacological treatment rates were 19.1 % and 0.9 % in school-age children/adolescents with and without ADHD, respectively. We estimated that for each individual using medication without a formal ADHD diagnosis, there are three patients with a formal diagnosis who might benefit from medication but do not receive it in the US. Our results indicate both overtreatment/misuse of medication in individuals without ADHD and pharmacological undertreatment in youths with the disorder. Our findings reinforce the need for public health policies improving education on ADHD and discussions on the benefits and limitations of ADHD medications.
Text
Assessing undertreatment and overtreatment_misuse of ADHD medications
- Author's Original
More information
Accepted/In Press date: 1 June 2021
e-pub ahead of print date: 3 June 2021
Published date: 1 September 2021
Additional Information:
Funding Information:
This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - Finance Code 001, and by the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazilian public funding agencies.
Funding Information:
This study was financed in part by the Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - Brasil (CAPES) - Finance Code 001, and by the Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico (CNPq), Brazilian public funding agencies.
Publisher Copyright:
© 2021 Elsevier Ltd
Keywords:
ADHD, Pharmacological interventions, Prevalence, Stimulants, Treatment
Identifiers
Local EPrints ID: 451000
URI: http://eprints.soton.ac.uk/id/eprint/451000
ISSN: 0149-7634
PURE UUID: 247eeb07-67cd-4bdd-8bf9-4c6b2b28d399
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Date deposited: 01 Sep 2021 16:31
Last modified: 17 Mar 2024 03:37
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Contributors
Author:
Rafael Massuti
Author:
Carlos Renato Moreira-maia
Author:
Fausto Campani
Author:
Márcio Sônego
Author:
Julia Amaro
Author:
Gláucia Chiyoko Akutagava-martins
Author:
Luca Tessari
Author:
Guilherme V. Polanczyk
Author:
Luis Augusto Rohde
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