Time to Medication Initiation in School-age Children With ADHD in Developmental-Behavioral Pediatrics.
Sushma S Kasinathan, Lynne C Huffman, Ingrid Luo and 1 others
PMID 41945689WHAT IT FOUND
About 59% of school-age children diagnosed with ADHD in developmental-behavioral clinics were prescribed medication within a year, with a median wait of 4 days.
Children waited longer if a psychologist diagnosed them, if they were Asian, or if they had co-occurring conditions.
Key findings
01484 of 823 children (58.8%) were prescribed an ADHD medication within a year of diagnosis. The median wait was 4 days but the mean was 51 days, and a quarter were prescribed at the first diagnostic visit, so most started quickly while a substantial minority waited much longer.
02In adjusted analyses, medication started later for children who were Asian, who were diagnosed by a psychologist rather than a prescribing clinician, or who had one or more co-occurring conditions, and earlier for older children and those with combined or hyperactive-impulsive ADHD.
03In a post hoc analysis, having already been prescribed an SSRI was linked to later ADHD medication, and once that was accounted for the link between having three or more co-occurring conditions and later medication was no longer statistically significant.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
All the records came from one subspecialty practice, so the figures may not hold in other clinics or other parts of the country. Only the structured parts of the record were used, not the free-text notes, so symptom severity and family preferences and values were never measured. The study period overlapped the COVID-19 pandemic and the national shortage of stimulant medications, and the authors did not account for either. Any child not prescribed medication within a year of diagnosis was counted as not prescribed in that window, so the study says nothing about children who started later than a year.
Declared interests
The authors state that they have no conflicts of interest to disclose. The supplied text does not say who funded the study.
The easy way to misread this
Do not read the later start of medication among Asian children as proof that clinicians are deciding differently because of a child's ethnicity. This is one practice's records, the study could not see symptom severity or family preferences and values, and the authors themselves call for further work to explain the difference rather than concluding bias.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →