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J Am Acad Child Adolesc Psychiatry. 2019 Jul 11. pii: S0890-8567(19)30452-6. doi: 10.1016/j.jaac.2019.06.010. [Epub ahead of print]

Attention-Deficit/Hyperactivity Disorder Medication and Unintentional Injuries in Children and Adolescents.

Author information

1
Karolinska Institutet, Stockholm, Sweden. Electronic address: laura.ghirardi@ki.se.
2
Karolinska Institutet, Stockholm, Sweden; School of Medical Sciences, Örebro University, Örebro, Sweden.
3
Karolinska Institutet, Stockholm, Sweden.
4
School of Public Health, Indiana University, Bloomington.
5
Center for Health Statistics, University of Chicago, IL.
6
Karolinska Institutet, Stockholm, Sweden; Indiana University, Bloomington, IN.

Abstract

OBJECTIVE:

Our objective was to determine whether ADHD medication is associated with a decreased risk of unintentional injuries in children and adolescents in the United States across sexes, age groups and injury types.

METHOD:

We used de-identified inpatient, outpatient, and filled prescription claims data from the Truven Health MarketScan® Research Databases. Individuals were followed from January 1, 2005, date of first ADHD diagnosis or medication prescription, or age 6, whichever occurred last, until December 31, 2014, first healthcare insurance disenrollment, or the first year at which their age was recorded as 19, whichever occurred first. A person was considered on ADHD medication during a given month if a prescription was filled in that month. The outcome was defined as emergency department visits for injuries, including traumatic brain injuries, with unintentional causes. Odds of having the outcome were compared between medicated and un-medicated months at the population-level and in within-individual analyses using logistic regression.

RESULTS:

Among 1 968 146 individuals diagnosed with ADHD or receiving ADHD medication, 87 154 had at least one event. At the population-level, medication use was associated a lower risk of injuries, both in boys (OR= 0.85; 95% CI: 0.84-0.86) and girls (OR=0.87; 95% CI: 0.85-0.89). Similar results were obtained from within-individual analysis among male (OR= 0.72; 95% CI: 0.70-0.74) and female (OR= 0.72; 95% CI: 0.69-0.75) children, and among male (OR= 0.64; 95% CI: 0.60-0.67) and female (OR= 0.65; 95% CI: 0.60-0.71) adolescents. Similar results were found for traumatic brain injuries.

CONCLUSION:

ADHD medication use was associated with a reduction of different types of unintentional injuries in children and adolescents of both sexes.

KEYWORDS:

Children; attention-deficit disorder with hyperactivity/drug therapy

PMID:
31302218
DOI:
10.1016/j.jaac.2019.06.010

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