JASON E. KEMNER, M.P.H., is Associate Director, Medical Science. Liaison, Ortho Urology, McNeil Consumer and Specialty Products,. Fort Washington, PA.
REPORTS
Methylphenidate formulation
REPORTS
Effect of methylphenidate formulation on treatment patterns and use of emergency room services JASON E. KEMNER AND MAUREEN J. LAGE
A
ttention-deficit/hyperactivity disorder (ADHD) is one of the most frequently diagnosed childhood mental disorders, with a frequency of 8–10% in school-age children.1 Children with ADHD can suffer from academic impairments and social dysfunction and have a higher risk of both cigarette smoking and substance abuse.2,3 Children and adolescents diagnosed with ADHD are more likely to suffer unintentional injuries,4 and young adults with the disease have an increased risk of driving accidents.5-7 Although ADHD is typically thought of as affecting mostly children, the disorder persists into adulthood for 10–60% of those who were diagnosed as children.8,9 As with children, there are significant costs associated with ADHD in adults. Adults with ADHD tend to have higher medical bills,10 less education,11 and higher rates of incarceration12 than adults without the disorder. In addition, adults with ADHD are less likely to be employed,13,14 while those who are employed are more likely to perform poorly, regularly change employment, or quit their jobs.15,16 Stimulants are commonly prescribed as first-line therapy for ADHD
Purpose. The treatment patterns of and use of emergency room services by patients with attention-deficit/hyperactivity disorder (ADHD) who initiated therapy with thrice-daily, immediate-release (IR) methylphenidate versus once-daily, extendedrelease (ER) oral system methylphenidate were studied. Methods. Using a large claims database, patients who were newly initiated on either ER methylphenidate or IR methylphenidate were retrospectively identified. Analysis of covariance was used to examine differences in treatment patterns between individuals who initiated therapy on ER methylphenidate and those who initiated therapy on IR methylphenidate. Multivariate regressions were used to examine the probability of visiting the emergency room and the number of visits to the emergency room. Results. Of the 5939 patients who met the inclusion criteria, 4785 were initiated on ER methylphenidate and 1154 were initiated on IR methylphenidate. Significantly fewer patients initiated on ER methylphenidate had a 15- or 30-day gap in therapy or switched to another ADHD medication (p
