Abstract
BACKGROUND: Following a diagnosis of Attention-deficit/hyperactivity disorder (ADHD) many children require immediate use of pharmacological agents for symptom control, while for some children a trial of non-pharmacological management may be warranted initially. AIM: To study and identify the clinical and socio-economic factors associated with immediate use of pharmacotherapy versus non pharmacological management in children with newly diagnosed ADHD. METHODS: A retrospective cross sectional study design using chart review was conducted in child and adolescent psychiatry services of a tertiary care hospital. The medical records between 2018 and 2020 were reviewed. The socio-demographic factors, symptom profiles and comorbidities were recorded. Descriptive statistics and Binary Logistic regression analyses were calculated for factors associated with use versus non-use of pharmacotherapy. RESULTS: 187 patients screened positive for ADHD at the walk-in clinic and after detailed assessments, 101 were diagnosed with ADHD. With every one-point increase in Vanderbilt ADHD Parent Rating Scale (VADPRS) severity score, there is 1.2 times [P = 0.002; Exp(B) = 1.281; 99% CI: 1.089-1.494] higher likelihood of getting a pharmacological prescription for ADHD. Combined presentation has 3.8 times [P = 0.015; Exp(B) = 3.808; 99% CI: 1.295-11.198] higher likelihood of getting a pharmacological prescription compared to only hyperactive/impulsive and inattentive presentations. Among the socio-demographic variables, no statistically significant variables were observed, although the odds ratios among all social categories displayed a meaningful trend. CONCLUSION: Pharmacotherapy for ADHD at initial diagnosis is strongly predicted by the severity of ADHD and other socio-economic variable that may require equal attention in the coming years.