While attention deficit hyperactive disorder (ADHD) is widely recognized in children, the condition is often underdiagnosed or undertreated in adults.
Research shows that about 4.4% of adults in the United States have ADHD, but less than one-third of them have been diagnosed. The most effective treatment option for ADHD in adults includes a combination of prescription medication and behavioral therapy. However, a new analysis by Evernorth Research Institute, presented at the 2023 AcademyHealth Annual Research Meeting (ARM), shows that while the prevalence of this multimodal treatment of ADHD in adults has increased from 12.9% in 2017 to 21.4% in 2021, 25% of patients still get no treatment at all.
Prevalence of ADHD treatment among newly diagnosed UC adults, 2017-2021
“ADHD in adults presents itself in many different ways, including the inability to focus or prioritize tasks, poor organizational skills, restlessness, and forgetfulness, and too often goes undiagnosed,” said Dr. Urvashi Patel, PhD, vice president of the Evernorth Research Institute. “ADHD can make getting through everyday tasks difficult, it can lead to frustration and irritability, and it can impact self-esteem. Without proper management, untreated ADHD in adults can also lead to mental health issues such as anxiety and depression.”
Socioeconomic factors and provider variation can impact ADHD treatment
The study, which is based on the anonymized and aggregated claims data of 495,180 adults with diagnosed ADHD, also uncovered that social and economic factors impact the prevalence of ADHD treatment. For example, people 50 and older were less likely to receive full-scope treatment for ADHD, compared with people 18-34. Men, people with more than one chronic condition, people living in socially disadvantaged areas, and people who don’t have health insurance through an employer were also significantly less likely to receive a combination of prescription medication and behavioral therapy.
The Evernorth analysis also shows that patients who were diagnosed with ADHD by a nurse practitioner, physician assistant, or a behavioral care provider were more likely to receive the full spectrum of treatment than those who were diagnosed by a physician.
“This finding has implications for reducing health care costs and improving the quality of care,” said Dr. Stuart Lustig, national medical executive for Behavioral Health at Evernorth. “If the quality of treatment from nurse practitioners, physician assistants, and behavioral care providers is proving to be effective, then shifting ADHD treatment and screening to these providers may help reduce downstream costs and improve patient outcomes.”