OBJECTIVE: To describe the characteristics and medication treatment patterns of adult patients with attention-deficit/hyperactivity disorder (ADHD) prescribed atomoxetine in Japan.
METHODS: A retrospective analysis of insurance claims data was conducted using the Japan Medical Data Center database. Adults (≥18 years) with ADHD who had ≥1 atomoxetine claim from 1 January 2013, to 31 December 2014, and ≥180 days of follow-up were included. First atomoxetine claim defined the index date. Patient characteristics included age, gender, and comorbid conditions. Treatment patterns assessed included rates of atomoxetine discontinuation, switching, persistence, adherence (assessed via the medication possession ratio), and use of concomitant medications.
RESULTS: A total of 457 adults met all inclusion criteria; mean (SD) age was 32.7 (10.4) years, and 61% of patients were male. Nearly 72% of the patients had at least one comorbid mental health condition in the baseline period; depression (43.8%) and insomnia (40.7%) were the most common mental comorbidities. Most common physical comorbidities were chronic obstructive pulmonary disease (14.4%) and diabetes (12.9%). Psychotropics were received by 59.7% of patients during baseline period and by 66.0% during follow-up period; however, only 6.6% received psychotropics concomitantly with atomoxetine. Overall, 40.0% of adults discontinued atomoxetine and 65.9% were persistent with atomoxetine therapy at 3 months post-index date. Mean (SD) atomoxetine medication possession ratio was 0.57 (0.25), and 25.4% switched to an alternative ADHD therapy; methylphenidate (22.4%) and psychotropics (77.6%) were the most common medications to switch to. Nearly 8% augmented atomoxetine with an alternative ADHD therapy.
CONCLUSIONS: In this observational study, a majority of adults with ADHD treated with atomoxetine were still persistent with therapy at 3 months post-index date, with one-quarter switching to alternative ADHD therapy. Higher proportions of both mental and physical comorbidities, along with greater use of psychotropic medications in the baseline period, were observed among patients with ADHD prescribed atomoxetine.
