Impact of Medication Therapy on Social, Behavioral, and Employment Outcomes in Adults With ADHD

OBJECTIVE: Limited studies have explored the association between pharmacotherapy treatment and socio-behavioral and employment-related difficulties among adults with ADHD in U.S. This study aimed to evaluate and compare socio-behavioral and employment outcomes among adults with ADHD who were receiving stimulant treatment versus those who were not. METHODS: A retrospective cross-sectional study was conducted using the Medical Expenditure Panel Survey data from 2013-2019. Adults with ADHD were categorized into stimulant-treated versus not stimulant-treated groups. Multivariable logistic regression was utilized to assess the association between stimulant use and outcomes of interest (e.g., social, behavioral, and employment outcomes) and was reported using odds ratio (ORs). Propensity score matching was used to control for confounding and sub-group analyses were conducted by adherence to CNS stimulants. RESULTS: Among 1,290 (2,468,186 weighted) patients, 80.67% were stimulant-treated, and 19.33% were not treated with stimulants. No significant differences were found in the employment outcomes between the two groups in adjusted models. Sub-group analyses showed that adherent users of stimulants had higher odds of self-employment (OR = 2.10 [1.15, 3.82]) than non-adherent users. Stimulant-treated adults had higher odds of social limitations (OR = 3.16 [1.50, 6.69]), and lower odds of physical activity (OR = 0.29 [0.13, 0.66]) compared to those who were not treated with stimulants. CONCLUSION: Overall, these findings highlight important gaps in understanding the relationship between real-world functional outcomes and stimulants use in adults with ADHD and underscore the need for additional longitudinal and real-world studies to thoroughly understand the impact of ADHD medications on those outcomes.