(243) Prevalence and Patterns of ADHD Medication Use Among Children, Adolescents, and Young Adults: A Two-decade Analysis

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental condition that causes inattention, hyperactivity, and impulsivity, and negatively affects academic, social, and emotional functioning. Diagnosis and management of ADHD have garnered attention across the globe, reflecting variations in treatment approaches and medication use. Medications play a crucial role in the treatment plan for many individuals with ADHD, aiming to reduce symptoms and improve quality of life. However, patterns of ADHD medication use vary depending on age, gender, and geographical location.

Objectives: This study aimed to estimate annual prevalence rates and patterns of ADHD medication use among individuals aged ≤24 years in Quebec, by sex, age, deprivation index, and specialty of the first prescriber.

Methods: We conducted a population-based repeated cross-sectional study using data from the Quebec Integrated Chronic Disease Surveillance System among individuals aged ≤24 years covered by the public drug plan from 2000 to 2022. We identified all ADHD medication users - those having claimed at least one prescription - within the fiscal year and calculated crude and age-adjusted annual prevalence rates and 95% confidence intervals (CIs), globally and by sex, age group, specialty of the first prescriber, material and social deprivation and medication classes.

Results: ADHD medication prevalence increased from 2.01% (95% CI: 1.97%-2.06%) in 2000-2001 to 7.59% (95% CI: 7.50%-7.68%) in 2022-2023, stabilizing after 2016-2017. Age-adjusted prevalence consistently remained higher in males than females over the study period (e.g., 9.08% in males and 6.03% in females in 2022-2023). A notable increase was seen in the 12-17 age group, though this trend reversed in the last five years. Meanwhile, the 18-24 age group's prevalence did not decline. Higher rates were seen among those with material deprivation, and over half of ADHD medication prescriptions originated from family physicians. While non-stimulant use has grown since 2005, stimulants, particularly methylphenidate, remained the predominant treatment despite a decrease in usage – with over 90% of all ADHD medication users using it in 2000-2001 to around 65% in 2022-2023.

Conclusions: ADHD medication use among Quebec's youth has significantly increased in the past 20 years, with stabilization in recent years. Males and certain age groups have shown higher prevalence, but socioeconomic disparities and primary care's pivotal role in prescribing paint a nuanced picture of ADHD management. Treatment patterns have evolved over two decades with new medication availability and changes in prescribing practices.