RT Journal
A1 Zito J, Safer DJ, dosReis S, Magder LS, Gardner JF, Zarin DA
T1 PSychotherapeutic medication patterns for youths with attention-deficit/hyperactivity disorder
JF Archives of Pediatrics & Adolescent Medicine
JO Archives of Pediatrics & Adolescent Medicine
YR 1999
FD December 1
VO 153
IS 12
SP 1257
OP 1263
DO 10.1001/archpedi.153.12.1257
UL http://dx.doi.org/10.1001/archpedi.153.12.1257
AB Objectives 
    (1) To describe temporal patterns of office visits for attention-deficit/hyperactivity disorder (ADHD) and stimulant treatment for 5- to 14-year-old US youths; (2) to compare youth visits for ADHD with and without medication according to patient demographics, physician specialty, reimbursement source, and comorbid diagnoses; and (3) to compare office visits for youths with ADHD in relation to common medication patterns (stimulants alone, stimulants with other psychotherapeutic medication, and nonstimulant psychotherapeutic medications alone).Design 
    Survey based on a national probability sample of office-based physicians in the United States.Setting 
    Physician offices.Participants 
    A systematically sampled group of office-based physicians.Main Outcome Measures 
    National estimates of office visits for ADHD and psychotherapeutic drug visits for ADHD for each year and for a combined 8-year period.Results 
    Youth visits for ADHD as a percentage of total physician visits had a 90% increase, from 1.9% in 1989 to 3.6% in 1996. Stimulant therapy within ADHD youth visits rose from 62.6% in 1989 to 76.6% in 1996. While the majority of non-ADHD youth visits were conducted by primary care physicians, one third of ADHD youth visits were managed by psychiatry and neurology specialists. Health maintenance organization insurance was the reimbursement source for 17.9% of non-ADHD youth visits but only 11.7% of ADHD youth visits. Complex medication therapy was more likely to be prescribed by psychiatrists and less likely to be related to visits with health maintenance organization reimbursement.Conclusions 
    National survey estimates in the 1990s confirm the substantial increase in visits for youths diagnosed as having ADHD, with more than three quarters of these visits associated with psychotherapeutic medication treatment. Physician specialty and reimbursement source variables identify distinct patient populations with a gradient in psychotherapeutic medication patterns from single-drug standard (stimulant) therapy to complex multidrug treatment regimens for which evidence-based scientific information is lacking.