(PS14-95) Navigating Medication Adherence Challenges in ADHD Treatment: A Systematic Review

Most people prescribed medication do not take their medication as indicated by their prescribing physician. In fact, medication nonadherence is reported in around 50 to 65% of the general population (Sokol et al., 2005). Amongst individuals with a diagnosis of Attention-Deficit/Hyper-Active Disorder (ADHD) stimulant medications represent a first line treatment option (Chan et al., 2016), with medication alone or in conjunction with therapy consistently resulting in symptom reduction (Faraone et al., 2006). However, the symptoms of ADHD (i.e. inattention, impulsivity) can act as barriers to adherence of prescription protocol (Sonney & Insel, 2019)). Medication adherence is particularly important for individuals with ADHD given that absence of treatment can result in poor job stability, and difficulties with relationships (Hoza, 2007), among other difficulties. As such, providing intervention or support to improve medication adherence for individuals with ADHD is important. Despite several studies examining how best to provide such services, no consensus has been reached as to how best to improve medication adherence in individuals with ADHD. Therefore, the purpose of the proposed study was to conduct a systematic review of the literature examining and summarizing what is known about the efficacy of intervention techniques utilized to improve adherence in individuals with ADHD. A systematic search of Pubmed and Psych Info resulted in 1,381 articles, which were reviewed for inclusion criteria: a) adherence intervention trial and b) sample of individuals with ADHD who were prescribed medication. Six articles were retained and will be summarized in this study. The limited literature on this topic did not lend itself to quantitative analyses, however, PRISMA-P guidelines for systematic review were adhered to (Moher., et al., 2015). Across the six articles, three types of interventions (cognitive behavioral therapy [CBT], psychoeducation, and text messaging reminder systems) were examined. Results indicated that although all three types of interventions resulted in improvements in medication adherence, there was variability in their efficacy across different ages and in the face of comorbid diagnosis, and in their feasibility and utility of implementation. Additionally, significant variability in the ways in which medication adherence is defined and assessed were noted. These results have implications for future directions of research and for the development of more efficacious approaches to improving the adherence of medication regiments for individuals with ADHD.