Abstract
BACKGROUND: Little is known about the impact of healthcare structural changes and socioeconomic indices, such as deprivation, mental health needs, and inequalities, on attention-deficit hyperactivity disorder (ADHD) medication prescribing across different regions in England.
OBJECTIVE: The objective was to examine trends in ADHD medication prescribing and explore their association with socioeconomic factors.
METHODS: A population-level observational study was conducted using the English Prescribing Dataset (from April 2019 to March 2024) published by the NHS Business Services Authority and the OpenPrescribing platform (Bennett Institute for Applied Data Science, University of Oxford). The study examined trends in five licensed ADHD medications at national, regional and integrated care board (ICB) levels, using linear regression and a generalised additive model to explore the association between socioeconomic factors and prescription rates.
FINDINGS: The prescriptions increased significantly from 25.17 items per 1000 population in 2019/20 (pre-COVID-19) to 41.55 items in 2023/24 (post-COVID-19), with an average annual increase of 18% nationally. Methylphenidate remained the most prescribed medication, while lisdexamfetamine showed the highest growth rate (55% annually, 95% CI 40% to 71%, p<0.01). Significant regional variations were observed, with London experiencing the highest annual increase (28%), and the Northeast and Yorkshire the lowest (13%). Socioeconomic factors, including ethnicity and deprivation, were significantly associated with ADHD prescription rates (p<0.05).
CONCLUSIONS: Findings reveal a substantial increase in ADHD medication use in England following the COVID-19 pandemic, with significant variations at regional and ICB levels and complex socioeconomic influences.
CLINICAL IMPLICATIONS: Findings highlight the need to understand and address drivers of disparities in ADHD care while optimising management strategies across diverse populations.
| Original language | English |
|---|---|
| Article number | 301384 |
| Number of pages | 8 |
| Journal | BMJ mental health |
| Volume | 28 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 11 Mar 2025 |
Bibliographical note
Copyright © Author(s) (or their employers(s)) 2025. Re-use permitted under CC BY-NC. Published by BMJ Group.This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially,
and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial.
See: https://creativecommons.org/licenses/by-nc/4.0/.
Data Access Statement
Data are available in a public, open access repository. All data used in this study are publicly available. The data supporting this study’s findings are available from the NHS study (https://www.nhsbsa.nhs.uk).Keywords
- Humans
- Attention Deficit Disorder with Hyperactivity/drug therapy
- England/epidemiology
- Central Nervous System Stimulants/therapeutic use
- Social Class
- Practice Patterns, Physicians'/trends
- Child
- Drug Prescriptions/statistics & numerical data
- COVID-19/epidemiology
- Methylphenidate/therapeutic use
- Male
- Female
- Adolescent
- Lisdexamfetamine Dimesylate/therapeutic use
- Atomoxetine Hydrochloride/therapeutic use
- State Medicine