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.
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