Effect of long-acting versus short-acting stimulants for the treatment of Attention Deficit Hyperactivity Disorder (ADHD) on emergency room visits using Medical Expenditure Panel Survey (MEPS) data

Abstract

Objective: Emergency room (ER) visits are perceived with high costs and unpredictable outcomes. Although the association between Attention Deficit Hyperactivity Disorder (ADHD), stimulants and ER visits has been studied, the difference between the types of stimulants in terms of risk of ER visits has not been studied. Our objective is to identify the difference between the effects of long-acting and short-acting stimulant use in ADHD on ER visits in 18- to 35-year-old adults (n=636) in the year 2011. Methods: This retrospective secondary data analysis used the Medical Expenditure Panel Survey data for the year 2011. Univariate and multivariate logistic regression were used to evaluate risk factors, influencing the type of stimulant use on ER visits. Risk factor and stimulant interactions were also included. Key findings: The risk of ER visits in long-acting stimulant users, among the uninsured, on adjusting for race, marital and insurance status, is 14.25 times (P=0.001) the risk of ER visits in short-acting stimulant users. If they are insured, the risk of ER visits in long-acting stimulant users is 1.83 times the risk of ER visits in short-acting stimulant users (P=0.26). Conclusions: Long-acting stimulants increase the risk of ER visits for people who do not have insurance. Therefore, besides the type of stimulants, lack of insurance is also a risk factor for increased ER visits for young ADHD adult population in the USA.