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Rates and Predictors of Adherence to Psychotropic Medications in Children with Autism Spectrum Disorders

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Abstract

Medication adherence in children is poor, particularly among those with chronic or mental health disorders. However, adherence has not been fully assessed in autism spectrum disorders (ASDs). The validated proportion of days covered method was used to quantify adherence to psychotropic medication in Medicaid-eligible children who met diagnostic criteria for ASD between 2000 and 2008 (N = 628). Among children prescribed attention deficit hyperactivity disorder (ADHD) medications, antidepressants, or antipsychotics, 44, 40 and 52 % were adherent respectively. Aggressive behaviors and abnormalities in eating, drinking, and/or sleeping, co-occurring ADHD, and the Medication Regimen Complexity Index were the most significant predictors of adherence rather than demographics or core deficits of ASD. Identifying barriers to adherence in ASD may ultimately lead to improved treatment outcomes.

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Acknowledgments

Support for this grant was provided by the Centers for Disease Control and Prevention (CDC) Sponsored Autism and Developmental Disabilities Monitoring Network (CDC-RFA-DD06-601 and CDC-RFA-DD10-1002). Additional collaboration for this project came from the Commissioner of the Department of Health and Environmental Control (DHEC), who has designated the South Carolina Autism and Developmental Disabilities Monitoring (SCADDM) team as a bona fide agent of the Health Department to conduct surveillance of autism spectrum disorders. Content is the responsibility of the authors and does not necessarily represent the views of the funding agencies. The authors would like to acknowledge the South Carolina Budget & Control Board, Office of Research & Statistics, and Lydia King, PhD, Heather Kirby, and Wally Altman for providing exceptional technical assistance for this project. This manuscript was prepared as part of the first author’s dissertation.

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Authors and Affiliations

  1. Department of Public Health Sciences, College of Medicine, Medical University of South Carolina, 135 Cannon St. Ste 301, Charleston, SC, 29425, USA

    Sarah L. Logan, Kelly S. Hunt, Elizabeth Garrett-Mayer & Joyce S. Nicholas

  2. Department of Pediatrics, College of Medicine, Medical University of South Carolina, 135 Rutledge Ave MSC 567, Charleston, SC, 29425-5670, USA

    Laura Carpenter & Jane Charles

  3. University of California, San Diego, 9500 Gilman Dr., La Jolla, San Diego, CA, 92093, USA

    R. Scott Leslie

  4. Medical University of South Carolina, 176 Croghan Spur Rd. Ste. 104, Charleston, SC, 29407, USA

    Sarah L. Logan

Authors
  1. Sarah L. Logan
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  2. Laura Carpenter
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  3. R. Scott Leslie
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  4. Kelly S. Hunt
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  5. Elizabeth Garrett-Mayer
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  6. Jane Charles
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  7. Joyce S. Nicholas
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Corresponding author

Correspondence to Sarah L. Logan.

Appendices

Appendix 1

See Table 7.

Table 7 ASD-associated aberrant behaviors and diagnostic criteria
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Appendix 2

See Table 8.

Table 8 Classification of psychotropic medications
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Logan, S.L., Carpenter, L., Leslie, R.S. et al. Rates and Predictors of Adherence to Psychotropic Medications in Children with Autism Spectrum Disorders. J Autism Dev Disord 44, 2931–2948 (2014). https://doi.org/10.1007/s10803-014-2156-0

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