A Scoping Review on Strategies that Enhance Medication Adherence in Children and Adolescents with Attention Deficit Hyperactivity Disorder and Associated Outcomes

The goal of this review was to summarize interventions aimed at improving medication adherence in pediatric ADHD. Specifically, we sought to address questions regarding the prevalence of non-adherence, available interventions, assessment methods, intervention effects on adherence and outcomes, and barriers to adherence.

We identified 13 studies evaluating eight types of interventions: education-based programs, behavioral treatment, combined psychoeducation and behavioral treatment, digital health approaches, adjunctive therapy, near-infrared spectroscopy, nursing support, and written informed consent. All interventions demonstrated significant improvements in medication adherence compared to controls or pre-intervention baselines. The reported prevalence of non-adherence varied widely (4.8%-77%), likely influenced by diverse measurement tools. Major barriers included parental beliefs, side effects, perceived inefficacy, socioeconomic factors, and healthcare system issues.

Non-adherence to ADHD medication in children can have detrimental consequences. While interventions have shown promise in enhancing adherence, multidimensional, theory-based approaches combining education, behavioral strategies, and digital techniques are needed. Digital health adoption presents opportunities but requires further research on long-term effectiveness. Interdisciplinary teams, including pharmacists, psychologists and psychiatrists can play a key role. Addressing parental beliefs, side effect concerns, socioeconomic factors, and healthcare barriers is crucial. Tailoring interventions to individual needs and barriers may optimize adherence and improve outcomes.