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Association Between Medication Use for Attention-Deficit/Hyperactivity Disorder and Risk of Motor Vehicle Crashes
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Center for Health Statistics, University of Chicago, Chicago IL, United States.
Center for Health Statistics, University of Chicago, Chicago IL, United States; Department of Psychological and Brain Sciences, Indiana University, Bloomington, United States.
Center for Health Statistics, University of Chicago, Chicago IL, United States.
Center for Health Statistics, University of Chicago, Chicago IL, United States.
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2017 (English)In: JAMA psychiatry, ISSN 2168-6238, E-ISSN 2168-622X, Vol. 74, no 6, p. 597-603Article in journal (Refereed) Published
Abstract [en]

IMPORTANCE: Motor vehicle crashes (MVCs) are a major public health problem. Research has demonstrated that individuals with attention-deficit/hyperactivity disorder (ADHD) are more likely to experience MVCs, but the effect of ADHD medication treatment on the risk of MVCs remains unclear.

OBJECTIVE: To explore associations between ADHD medication use and risk of MVCs in a large cohort of patients with ADHD.

DESIGN, SETTING, AND PARTICIPANTS: For this study, a US national cohort of patients with ADHD (n = 2 319 450) was identified from commercial health insurance claims between January 1, 2005, and December 31, 2014, and followed up for emergency department visits for MVCs. The study used within-individual analyses to compare the risk of MVCs during months in which patients received ADHD medication with the risk of MVCs during months in which they did not receive ADHD medication.

EXPOSURES: Dispensed prescription of ADHD medications.

MAIN OUTCOMES AND MEASURES: Emergency department visits for MVCs.

RESULTS: Among 2 319 450 patients identified with ADHD, the mean (SD) age was 32.5 (12.8) years, and 51.7% were female. In the within-individual analyses, male patients with ADHD had a 38%(odds ratio, 0.62; 95% CI, 0.56-0.67) lower risk of MVCs in months when receiving ADHD medication compared with months when not receiving medication, and female patients had a 42%(odds ratio, 0.58; 95% CI, 0.53-0.62) lower risk of MVCs in months when receiving ADHD medication. Similar reductions were found across all age groups, across multiple sensitivity analyses, and when considering the long-term association between ADHD medication use and MVCs. Estimates of the population-attributable fraction suggested that up to 22.1% of the MVCs in patients with ADHD could have been avoided if they had received medication during the entire follow-up.

CONCLUSIONS AND RELEVANCE: Among patients with ADHD, rates of MVCs were lower during periods when they received ADHD medication. Considering the high prevalence of ADHD and its association with MVCs, these findings warrant attention to this prevalent and preventable cause of mortality and morbidity.

Place, publisher, year, edition, pages
American Medical Association , 2017. Vol. 74, no 6, p. 597-603
National Category
Psychiatry
Research subject
Psychiatry
Identifiers
URN: urn:nbn:se:oru:diva-58785DOI: 10.1001/jamapsychiatry.2017.0659ISI: 000402867200011PubMedID: 28492937Scopus ID: 2-s2.0-85019411352OAI: oai:DiVA.org:oru-58785DiVA, id: diva2:1128561
Funder
Swedish Research Council, 20132280NIH (National Institute of Health), 1R01MH102221Forte, Swedish Research Council for Health, Working Life and Welfare, 2014-2780
Note

Funding Agency:

National Institute on Drug Abuse  K99DA040727

Available from: 2017-07-26 Created: 2017-07-26 Last updated: 2017-09-19Bibliographically approved

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