Factors Associated with Premature Treatment Discontinuation among Thai Children and Adolescents with Attention Deficit Hyperactivity Disorder [ADHD]
Chanvit Pornnoppadol MD1, Patcharin Seree EdD2, Niramon Yasinthorn MA1, Chutima Jangjit MA1, Sirinda Chanpen MSc1
Affiliation : 1 Department of Psychiatry, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand 2 National Institute for Child and Family Development, Mahidol University, Nakhon Pathom, Thailand
Objective : To identify factors that contributed to premature treatment discontinuation among Thai children and adolescents
with attention deficit hyperactivity disorder [ADHD].
Materials and Methods : This was a retrospective study. The parents of ADHD subjects were divided into three groups
which were based on their children’s adherence to treatment: 1) early discontinuation [ED] group, 2) late discontinuation
[LD] group, and 3) control group. The possible factors that might cause treatment discontinuation were collected through
chart reviews and interviews (telephone or face-to-face) by trained personnel. The Chi-squared and Kruskal-Wallis tests
were performed when appropriate to identify the associated factors. Multivariate logistic regression analyses (backward
stepwise method) were also utilized.
Results : A total of 375 parents of ADHD patients were recruited. The parents were separated into 3 groups where 195
parents were in the control group, while 105 and 75 were in the ED and LD groups, respectively. Multiple logistic regression
analyses revealed that factors associated with treatment discontinuation were increased age (adj. OR = 1.19), family income
> 50,000 baht/month (adj. OR = 2.48), parents’ knowledge of “Treatment of ADHD is unnecessary.” (adj. OR = 1.37) and
“Medication for ADHD is an essential intervention for ADHD” (adj. OR = 0.61). The reasons for treatment discontinuation
between ED and LD revealed that patients in the LD group experience more “intolerable side effects” (38.7% vs. 22.9%) and
less “improved or cured children” (16.0% vs. 29.5) compared to those in the ED group.
Conclusion : The significant factors that predicted premature treatment discontinuation among Thai children and adolescents
with ADHD were the age of the patients, family income, parents’ lack of knowledge of ADHD, and negative parental
attitudes toward the pharmacological management of ADHD.
Keywords : Treatment discontinuation, Attention deficit hyperactivity disorder, ADHD, Children and adolescents, Non- adherence
