Stimulant Medication Adherence—Theoretical Perspectives

Abstract

After 12 months of use, children with ADHD take their medication only 50% to 75% of the time, a proportion that decreases to less than 50% after three years of use. The Multimodal Treatment Study of ADHD documented that poor adherence to medication contributed to symptom recurrence. Over two years of use, children with ADHD who discontinued medication treatment deteriorated in comparison to those who continued use. Likewise, clinical treatment guidelines recommend that physicians pay close attention to medication adherence, noting that poor treatment adherence may contribute to treatment non–response. Though clinicians have developed strategies to address the problem of adherence among children with ADHD, few studies have investigated what contributes to early discontinuation of medications among children and adolescents with ADHD. In order to better understand the problem of treatment non–compliance, this article will apply four empirically based theoretical models of health behavior to the treatment adherence literature for children who take stimulants for ADHD. It is expected that clinicians can use the application of various models to better appreciate the complexities of treatment adherence in the care of children with ADHD.