Nonadherence to ADHD Medication in Adolescents Transitioning Into College

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ADHD medication

Nonadherence to ADHD medication in adolescents, especially during their transition to college, can have significant repercussions on academic performance and long-term goals. In a recent study, published in the Journal of Adolescent Health, 10 freshmen with ADHD were interviewed regarding their medication self-management experience as they transitioned to college life.

 

Nonadherence to medical treatment is a major problem, especially in adolescents and young adults whose nonadherence rates can be as high as 75% for chronic illnesses. Majority of nonadherence studies in adolescents have primarily focused on illnesses like asthma, cancer, HIV, and diabetes. However, very little adherence literature exists on conditions that affect mental health, like attention-deficit/hyperactivity disorder (ADHD) characterized by inattention, hyperactivity, and impulsivity. Nonadherence to ADHD medication can have significant consequences for individuals including greater symptom severity, poor academic performance, less productivity, decreased focus, and impaired communication skills. Long-term consequences can include the inability to successfully complete college degrees, little to no progress in career development, poor social life, and low work performance ratings. It is important to better understand the challenges individuals with ADHD face, especially while transitioning to college. Complications at this stage of life can have significant long-term repercussions on social health and career development.

A recent study, published in the Journal of Adolescent Health, interviewed 10 freshmen with ADHD, to better understand the experiences and challenges they face during their transition to college. All 10 participants were 21 years of age or younger, in their second semester of college, living away from home, and taking daily oral medication for their ADHD. Over the course of the study, several important themes emerged. For starters, participants reported not being fully prepared for the abrupt transition to independence in college. Before college, parents were highly involved in the participant’s medical care, whereas after transition to college, responsibilities were primarily shifted to the individuals themselves. Participants reported saying that the transition to college was a “smack in the face” and “kind of a shell shock”. Furthermore, purposeful nonadherence to medication was common amongst participants. This is due to inaccurate beliefs about their ADHD, the desire to avoid medication’s negative side effects, and the participant’s belief that they would eventually outgrow their ADHD. As a consequence of skipping medication, participants were more likely to skip and fail classes, and had difficulties focusing on particular tasks like studying or completing assignments. In addition, participants expressed pressure from peers to share their medication, which negatively affected their social functioning and adherence. Selling their medication impacted their daily functioning, whereas not selling their medication led to a loss of significant friendships and social standing. All 10 individuals expressed that ADHD was an isolating experience. They reported that guidance from higher year mentors with ADHD or academic counselors, specifically trained to work with ADHD individuals, could have made their transition much easier.

As a consequence of skipping medication, participants were more likely to skip and fail classes, and had difficulties focusing on particular tasks like studying or completing assignments. In addition, participants expressed pressure from peers to share their medication, which negatively affected their social functioning and adherence. Selling their medication impacted their daily functioning, whereas not selling their medication led to a loss of significant friendships and social standing. All 10 individuals expressed that ADHD was an isolating experience. They reported that guidance from higher year mentors with ADHD or academic counselors, specifically trained to work with ADHD individuals, could have made their transition much easier.

The study revealed that the transition to college for adolescents with ADHD can be a very daunting task. Freshmen with ADHD expressed not being prepared for the transition and lacking self-management skills. They also reported inaccurate beliefs regarding their condition, academic demands, and medication side-effects, which contributed to their nonadherence. Furthermore, this nonadherence contributed to negative impacts on school performance and social standing. Parents are encouraged to continually teach their children self-management skills, provide rationale for specific health behaviors, and continually be involved in their children’s care. Furthermore, continued psychoeducation, long after diagnoses, could help individuals understand their condition better and therefore cope with it more appropriately. Finally, better support systems, whether it be continual monitoring by parents, networking with peers that have ADHD, or counselors trained to work with ADHD individuals, can significantly improve adolescents transition to college.

 

Written By: Haisam Shah, BSc