Attention-Deficit/Hyperactivity Disorder Medication Use in Adolescents: The Patient's Perspective

Published:September 09, 2017DOI:



      The purpose of the study was to gain more insight into the attitudes of adolescents using medication for attention-deficit/hyperactivity disorder (ADHD).


      A cross-sectional study among adolescents (aged 12–18 years) who filled at least two prescriptions for ADHD medication in the preceding year was conducted. Adolescents were invited to fill in an online questionnaire containing questions on sociodemographics, health status, illness perceptions, medication adherence, and medication beliefs.


      We invited 1,200 adolescents of whom 181 adolescents (122 males, mean age 14.2 ± 1.7 years) completed the online questionnaire. They mostly used methylphenidate (n = 167; 92%) as a pharmacological treatment for ADHD. Half of the study population (n = 93; 51%) experienced side effects, such as decreased appetite and sleep problems. Most participants (n = 150; 83%) had an indifferent attitude (perceived low necessity and low concerns) toward their ADHD medication. More than half of the study population (n = 111; 61%) reported to be nonadherent based on the Medication Adherence Report Scale. The highest score of the Brief Illness Perception Questionnaire was on “treatment control,” suggesting that adolescents do think their medication is effective, despite their indifferent drug attitude.


      Most adolescents using ADHD medication had an indifferent attitude toward their medication and reported low adherence rates. These findings should be taken into account when treating adolescents with ADHD; regular counseling and monitoring of the pharmacological treatment might be useful to optimize treatment.


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        • American Psychiatric Association
        Diagnostic and statistical Manual of mental disorders (DSM-5) attention Deficit/hyperactivity disorder Fact Sheet.
        American Psychiatric Association, Washington, DC2013
        • Polanczyk G.V.
        • Salum G.A.
        • Sugaya L.S.
        • et al.
        Annual research review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents.
        J Child Psychol Psychiatry. 2015; 56: 345-365
        • Patton G.C.
        • Viner R.
        Pubertal transitions in health.
        Lancet. 2007; 369: 1130-1139
        • Birchwood J.
        • Daley D.
        Brief report: The impact of Attention Deficit Hyperactivity Disorder (ADHD) symptoms on academic performance in an adolescent community sample.
        J Adolesc. 2012; 35: 225-231
        • Bussing R.
        • Mason D.M.
        • Bell L.
        • et al.
        Adolescent outcomes of childhood attention-deficit/hyperactivity disorder in a diverse community sample.
        J Am Acad Child Adolesc Psychiatry. 2010; 49: 595-605
        • Stijntjes F.
        • Hassink-Franke L.
        • Kruishoop A.
        • et al.
        NHG-Standaard ADHD bij kinderen ‘Dutch GP Society standard: ADHD in children’.
        Huisarts Wet. 2014; 57: 584-594
        • National Health Care Institute
        The Drug Information System (GIPdatabank).
        (Available at:) (Accessed May 1, 2017)
        • Shier A.C.
        • Reichenbacher T.
        • Ghuman H.S.
        • Ghuman J.K.
        Pharmacological treatment of attention deficit hyperactivity disorder in children and adolescents: Clinical strategies.
        J Cent Nerv Syst Dis. 2012; 5: 1-17
        • Storebø O.J.
        • Krogh H.B.
        • Ramstad E.
        • et al.
        Methylphenidate for attention-deficit/hyperactivity disorder in children and adolescents: Cochrane systematic review with meta-analyses and trial sequential analyses of randomised clinical trials.
        BMJ. 2015; 351: h5203
        • Gajria K.
        • Lu M.
        • Sikirica V.
        • et al.
        Adherence, persistence, and medication discontinuation in patients with attention-deficit/hyperactivity disorder - a systematic literature review.
        Neuropsychiatr Dis Treat. 2014; 10: 1543-1569
        • McCarthy S.
        Pharmacological interventions for ADHD: How do adolescent and adult patient beliefs and attitudes impact treatment adherence?.
        Patient Prefer Adherence. 2014; 8: 1317-1327
        • Menckeberg T.T.
        • Bouvy M.L.
        • Bracke M.
        • et al.
        Beliefs about medicines predict refill adherence to inhaled corticosteroids.
        J Psychosom Res. 2008; 64: 47-54
        • Moldavsky M.
        • Sayal K.
        Knowledge and attitudes about attention-deficit/hyperactivity disorder (ADHD) and its treatment: The views of children, adolescents, parents, teachers and healthcare professionals.
        Curr Psychiatry Rep. 2013; 15: 377
        • Hébert J.
        • Polotskaia A.
        • Joober R.
        • Grizenko N.
        Adherence to psychostimulant medication in children with attention-deficit/hyperactivity disorder: The role of attitudes.
        J Can Acad Child Adolesc Psychiatry. 2013; 22: 317-323
        • Bussing R.
        • Zima B.T.
        • Mason D.M.
        • et al.
        ADHD knowledge, perceptions, and information sources: Perspectives from a community sample of adolescents and their parents.
        J Adolesc Health. 2012; 51: 593-600
        • Foundation for Pharmaceutical Statistics (SFK)
        ADHD: afnemende groei.
        (Available at:) (Accessed May 1, 2017)
        • Koster E.S.
        • Blom L.
        • Philbert D.
        • et al.
        The Utrecht pharmacy practice network for education and research: A network of community and hospital pharmacies in The Netherlands.
        Int J Clin Pharm. 2014; 36: 669-674
        • WHO Collaborating Centre for Drug Statistics Methodology
        Guidelines for ATC classification and DDD assignment.
        19th edition. Norwegian Institute of Public Health, Oslo2016
        • Horne R.
        • Weinman J.
        Self-regulation and self-management in asthma: Exploring the role of illness perceptions and treatment beliefs in explaining non-adherence to preventer medication.
        Psychol Health. 2002; 17: 17-32
        • Horne R.
        • Weinman J.
        • Hankins M.
        The beliefs about medicines questionnaire: The development and evaluation of a new method for assessing the cognitive representation of medication.
        Psychol Health. 1999; 14: 1-24
        • Broadbent E.
        • Petrie K.J.
        • Main J.
        • Weinman J.
        The Brief illness perception questionnaire.
        J Psychosom Res. 2006; 60: 631-637
        • Tommelein E.
        • Mehuys E.
        • Van Tongelen I.
        • et al.
        Accuracy of the Medication Adherence Report Scale (MARS-5) as a quantitative measure of adherence to inhalation medication in patients with COPD.
        Ann Pharmacother. 2014; 48: 589-595
        • Koster E.S.
        • Philbert D.
        • Winters N.A.
        • Bouvy M.L.
        Adolescents’ inhaled corticosteroid adherence: The importance of treatment perceptions and medication knowledge.
        J Asthma. 2015; 52: 431-436
        • Sjölander M.
        • Eriksson M.
        • Glader E.L.
        The association between patients’ beliefs about medicines and adherence to drug treatment after stroke: A cross-sectional questionnaire survey.
        BMJ Open. 2013; 3: e003551
        • Horne R.
        • Parham R.
        • Driscoll R.
        • Robinson A.
        Patient’s attitudes to medicines and adherence to maintenance treatment in inflammatory bowel disease.
        Inflamm Bowel Dis. 2009; 15: 837-844
        • Molteni S.
        • Giaroli G.
        • Rossi G.
        • et al.
        Drug attitude in adolescents: A key factor for a comprehensive assessment.
        J Clin Psychopharmacol. 2014; 34: 99-108
        • Emilsson M.
        • Gustafsson P.A.
        • Öhnström G.
        • Marteinsdottir I.
        Beliefs regarding medication and side effects influence treatment adherence in adolescents with attention deficit hyperactivity disorder.
        Eur Child Adolesc Psychiatry. 2017; 26: 559-571
        • Hommel K.A.
        • Odell S.
        • Sander E.
        • et al.
        Treatment adherence in paediatric inflammatory bowel disease: Perceptions from adolescent patients and their families.
        Health Soc Care Community. 2011; 19: 80-88
        • Koster E.S.
        • Philbert D.
        • de Vries T.W.
        • et al.
        “I just forget to take it”: Asthma self-management needs and preferences in adolescents.
        J Asthma. 2015; 52: 831-837
        • Ibrahim K.
        • Donyai P.
        Drug holidays from ADHD Medication: International experience over the Past four Decades.
        J Atten Disord. 2015; 19: 551-568
        • Martins S.
        • Tramontina S.
        • Polanczyk G.
        • et al.
        Weekend holidays during methylphenidate use in ADHD children: A randomized clinical trial.
        J Child Adolesc Psychopharmacol. 2004; 14: 195-205
        • Vervloet M.
        • Spreeuwenberg P.
        • Bouvy M.L.
        • et al.
        Lazy Sunday afternoons: The negative impact of interruptions in patients’ daily routine on adherence to oral antidiabetic medication. A multilevel analysis of electronic monitoring data.
        Eur J Clin Pharmacol. 2013; 69: 1599-1606
        • Desai M.
        • Oppenheimer J.J.
        Medication adherence in the asthmatic child and adolescent.
        Curr Allergy Asthma Rep. 2011; 11: 454-464
        • Ou H.T.
        • Feldman S.R.
        • Balkrishnan R.
        Understanding and improving treatment adherence in pediatric patients.
        Semin Cutan Med Surg. 2010; 29: 137-140
        • Taddeo D.
        • Egedy M.
        • Frappier J.Y.
        Adherence to treatment in adolescents.
        Paediatr Child Health. 2008; 13: 19-24
        • Brinkman W.B.
        • Sherman S.N.
        • Zmitrovich A.R.
        • et al.
        In their own words: Adolescent views on ADHD and their evolving role managing medication.
        Acad Pediatr. 2012; 12: 53-61
        • Charach A.
        • Yeung E.
        • Volpe T.
        • et al.
        Exploring stimulant treatment in ADHD: Narratives of young adolescents and their parents.
        BMC Psychiatry. 2014; 14: 110
        • Singh I.
        • Kendall T.
        • Taylor C.
        • et al.
        Young People’s experience of ADHD and stimulant medication: A Qualitative study for the NICE guideline.
        Child Adolesc Ment Health. 2010; 15: 186-192
        • Public health and health care
        Numbers and context: smoking and alcohol use.
        (Available at:) (Accessed May 1, 2017)
        • Chan E.
        • Fogler J.M.
        • Hammerness P.G.
        Treatment of attention-deficit/hyperactivity disorder in adolescents: A systematic review.
        JAMA. 2016; 315: 1997-2008