Pdg47 Outpatient Opioid Prescribing Among Patients With Rheumatoid Arthritis: Analysis of National Ambulatory Medical Care Survey, 2011-2016

Abstract

Objectives: The common pharmacotherapy for Attention Deficit Hyperactivity Disorder (ADHD) includes the use of stimulants and non-stimulants. The objective of this study was to examine the prescribing practices of ADHD medications based on physician specialties and to determine the factors associated with their prescription among children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD). Methods: This retrospective cross-sectional study used the National Ambulatory Medical Care Survey data (NAMCS) from 2011-2016. The study included children and adolescents (aged 4-17 years) with a diagnosis of ADHD identified using the International Classification of Diseases (ICD-9-CM ad ICD-10-CM) codes. Descriptive weighted analysis examined the prescribing practices of stimulants and non-stimulants, while multivariable logistic regression evaluated factors associated with ADHD medication use in general, and non-stimulants use in specific among children with ADHD. Results: During the study period, there were 50.3 million (95% CI: 42.5-58.1) visits by children and adolescents with ADHD. Most of patients were boys (69.85%), White (84.58%), and aged 9-12 years (39.84%). ADHD medications were prescribed in 79.80% of the patients. Stimulant medications were mainly prescribed by pediatricians (53.65%), while non-stimulants were mainly prescribed by psychiatrists (50.95%). The multivariable logistic regression revealed that Hispanics ([OR] = 0.55, 95% CI: 0.37-0.82) had a lower likelihood of being prescribed ADHD medications, while patients from South region (OR = 2.02, 95% CI: 1.19-3.42) had a greater likelihood of being prescribed ADHD medications as compared to West region. For non-stimulants, Hispanics (OR = 0.43, 95% CI: 0.19-0.97) were associated with a lower likelihood of non-stimulant prescription. Pediatric specialty (OR = 0.34, 95% CI: 0.12-0.97) was associated with decreased likelihood of prescribing nonstimulant medications, compared to psychiatric specialty. Conclusions: Stimulants and non-stimulants were commonly prescribed among children and adolescents with ADHD. Various demographic and provider factors were associated with prescription of ADHD medications.