A preliminary study of factors affecting adherence to medication in clinic children with attention-deficit/hyperactivity disorder

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is a common and chronic condition requiring long-term management. However, nonadherence to treatment and its reasons have not been studied in Indian children with ADHD. OBJECTIVE: To identify the factors affecting adherence to medication in clinic children and adolescents with ADHD. METHODS AND MATERIALS: Twenty-four children and adolescents newly diagnosed with ADHD on Kiddie schedule for affective disorders and schizophrenia – present and lifetime – were prescribed medication on an outpatient basis and followed-up to check their adherence to medication. Information regarding adherence was obtained from the parents on a proforma to assess the factors affecting the adherence to medication. RESULTS: Twenty (83.3%) subjects were nonadherent within the first month. The most common reasons as given by the parents for nonadherence to treatment were side-effects of medication in 13 (65%), lack of effectiveness of medication in 10 (50%), problems in hospital, like long waiting time and procedural delay, in 10 (50%), fear that the child will become addicted to medication in nine (45%), problems in accessing medication in eight (40%), careless attitude of caregivers in eight (40%) and high cost of medication in eight (40%). CONCLUSIONS: The rate of adherence to medication in this short-term follow-up of newly diagnosed children with ADHD was very low. Other than the commonly reported reasons in Western countries, there were some sociocultural and local reasons for nonadherence to treatment in our country. Efforts are needed to improve adherence to medication in children with ADHD.