Common Use of Stimulants and Alpha-2 Agonists to Treat Preschool Attention-Deficit Hyperactivity Disorder: A DBPNet Study.

Abstract

OBJECTIVE:

To describe the use of stimulants and alpha-2 agonists (A2As) for the treatment of preschool-aged children with attention-deficit hyperactivity disorder (ADHD) at 2 Developmental-Behavioral Pediatrics Research Network sites.

METHODS:

Demographic information, diagnoses, and medications prescribed by developmental-behavioral pediatricians (DBPs) were extracted from the electronic health record for all outpatient visits from January 1, 2010, to December 31, 2011. The subset of visits for children aged 2 to 5 years who had a diagnosis of ADHD was included in this analysis. Multivariable models were constructed to identify factors associated with prescribing stimulants and A2As.

RESULTS:

Over the 2-year period, 984 children with a diagnosis of ADHD were seen at 1779 visits. Of the 984 children, 342 (34.8%) were prescribed a stimulant, and 243 (24.7%) were prescribed an A2A. Both medications were prescribed at the same visit at least once during the 2-year period for 97 children (9.9%). Alpha-2 agonists were prescribed more often at site 2 than site 1 (OR [odds ratio] = 1.62, p = 0.015). Stimulants were more likely to be prescribed for older preschool-aged children (OR = 1.66, p < 0.001), and A2As were more likely to be prescribed for younger children (OR = 0.82, p = 0.02). Both stimulants and A2As were more likely to be prescribed to children with ADHD and comorbid conditions.

CONCLUSION:

Alpha-2 agonists are commonly used by some DBPs for preschool ADHD. Variation in the use of A2As across sites may indicate a lack of consensus on when to use these medications and suggests a need for comparative effectiveness research to better define the relative benefits and side effects of A2As and stimulants for the treatment of preschool ADHD.

• Authors: Nathan J Blum, Justine Shults, Elizabeth Harstad, Susan Wiley, Marilyn Augustyn, Jareen K Meinzen-Derr, Mark L Wolraich, William J Barbaresi
• Journal: Journal of developmental and behavioral pediatrics : JDBP (J Dev Behav Pediatr) Vol. 39 Issue 7 Pg. 531-537 (09 2018) ISSN: 1536-7312 [Electronic] United States
• PMID: 29851669 (Publication Type: Journal Article, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Adrenergic alpha-2 Receptor Agonists
• Central Nervous System Stimulants

Topics

• Adrenergic alpha-2 Receptor Agonists (therapeutic use)
• Attention Deficit Disorder with Hyperactivity (drug therapy)
• Central Nervous System Stimulants (therapeutic use)
• Child, Preschool
• Drug Prescriptions (statistics & numerical data)
• Female
• Humans
• Male
• Pediatricians (statistics & numerical data)
• Practice Patterns, Physicians' (statistics & numerical data)