The Covid pandemic has had a profound impact on children with attention deficit hyperactivity disorder (ADHD), particularly in terms of medication adherence and management. A new study conducted by researchers at the General Academic Pediatrics (GAP) clinic at the Children’s Hospital of the King’s Daughters (CHKD) in Norfolk, Virginia, has revealed concerning trends in ADHD medication refills and follow-up appointments during the pandemic. The study underscores the pandemic’s enduring effects on the health management of children and adolescents with ADHD, highlighting the need for re-engagement with healthcare providers to mitigate these disruptions. The findings were published in the journal BMC Psychiatry.
The study retrospectively analysed data from 396 children aged 8–18 with a history of ADHD, who had been medically managed with at least four prescription refills between January 2019 and May 2022. The researchers aimed to identify whether the pandemic disrupted ADHD medication regimens by examining prescription refill rates and the frequency of ADHD management appointments, including telehealth visits.
The findings are striking. The percentage of patients refilling their ADHD prescriptions during the pandemic months (April 2020–June 2022) dropped significantly compared to the pre-pandemic period (January 2019–March 2020). Before the pandemic, between 40% and 66% of patients refilled their prescriptions monthly, whereas during the pandemic, this rate fell to between 31% and 44%. The study also noted a similar decline in quarterly ADHD management appointments, with pre-pandemic rates ranging from 59% to 70% compared to 33% to 50% during the pandemic.
One of the key insights from the study is the relationship between appointment types and medication adherence. The researchers found that children who had a mix of virtual and in-person appointments had significantly higher rates of medication refills than those who only had in-person visits. This trend was consistent across racial demographics, although it highlighted a disparity: Black patients had fewer total appointments and medication refills compared to White patients, despite the option of telehealth being equally available. This finding points to a critical need for addressing racial inequities in healthcare access and adherence, especially in under-represented communities.
The study’s results suggest that the decrease in medication adherence during the pandemic was not solely due to logistical challenges but may also reflect broader issues, including the impact of changing daily routines and school schedules on children with ADHD. The unpredictability of remote learning and the disruption of established routines likely exacerbated challenges in maintaining a consistent medication schedule. The researchers noted that even after schools began transitioning back to in-person learning in 2021, medication refill rates did not return to pre-pandemic levels, indicating a sustained impact on ADHD management.
Moreover, the study raises concerns about the long-term consequences of these disruptions. ADHD is a condition that, when untreated, can lead to significant impairments in school performance, social interactions, and overall quality of life. The decrease in medication adherence observed in the study could have serious implications for the academic and social development of children with ADHD, particularly those from disadvantaged backgrounds.
Telehealth emerged as a potential solution to these challenges. The study found that telehealth appointments were associated with higher rates of medication adherence, suggesting that integrating telehealth into routine ADHD management could help overcome some of the barriers exacerbated by the pandemic. However, the study also highlighted disparities in telehealth usage, with Black patients less likely to have telehealth appointments than their White counterparts. This disparity suggests that while telehealth can be an effective tool, its benefits are not being equitably distributed, pointing to the need for targeted interventions to improve access to telehealth services among under-represented populations.
