Trends in Use of Telemedicine for Stimulant Initiation Among Children and Adults.

Trends in Use of Telemedicine for Stimulant Initiation Among Children and Adults.

Publication date: Jan 19, 2024

The authors sought to examine trends in stimulant initiation and follow-up care for attention-deficit hyperactivity disorder (ADHD) via telemedicine. This retrospective longitudinal study used national, deidentified commercial health insurance outpatient claims among children (ages 2-17 years; N=535,629) and adults (ages 18-64 years; N=2,116,160) from January 2019 through April 2022. Regression analyses were used to examine risk for stimulant initiation, whether initiation occurred via telemedicine or in-person care, and receipt of a follow-up visit. The mean monthly adjusted number of stimulant initiations per 100,000 enrollees was similar for children before and during the COVID-19 pandemic (prepandemic, 57 initiations; during pandemic, 56 initiations) but increased for adults (prepandemic, 27 initiations; during pandemic, 33 initiations). Initiations via telemedicine peaked at 53%-57% in April 2020 and dropped to about 14% among children and 28% among adults in April 2022. Telemedicine initiations were significantly more common among psychiatrists than among other prescribers (OR=3. 70, 95% CI=3. 38-4. 06 [children]; OR=3. 02, 95% CI=2. 87-3. 17 [adults]) and less common for rural residents (OR=0. 57, 95% CI=0. 40-0. 82 [children]; OR=0. 75, 95% CI=0. 61-0. 92 [adults]). Follow-up care was significantly more common among individuals whose care was initiated via telemedicine than among those receiving in-person care (OR=1. 09, 95% CI=1. 00-1. 19 [children]; OR=1. 61, 95% CI=1. 53-1. 69 [adults]). Many stimulant treatments were initiated via telemedicine. Proposed rules to prohibit controlled substance prescribing without an in-person evaluation would require significant changes in current practice, potentially limiting access to stimulant medications for ADHD.

Concepts Keywords
Monthly Amphetamine
Outpatient Attention deficit disorders
Retrospective Child psychiatry


Type Source Name
disease MESH ADHD
disease VO monthly
disease MESH COVID-19 pandemic
disease VO ProHIBiT
drug DRUGBANK Amphetamine

Original Article

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