Academic Outcomes in Primary and Secondary School Students Prescribed Long-Acting Stimulants for ADHD Management

Objective: This study examines the impact of long-acting stimulant (LAS) pharmacotherapy for ADHD on academic outcomes among students in grades K-12 using retrospective analysis of administrative data. Methods: ADHD diagnosis was identified based on ADHD management plans in school records, physician notes in billing records, and/or prescription records. Prescription records identified LAS-treated students ( n = 15,544), excluding those treated with immediate/intermediate-acting stimulants or atomoxetine. A control group without ADHD ( n = 204,681), and another with untreated ADHD ( n = 27,880) were also identified. The following outcomes were examined using multivariate regression: report card scores, standardized assessment exam performance, graduation from high school, school attendance, and transition to post-secondary education. Results: ADHD was associated with lower average report card scores and provincial assessment exam scores and increased frequency of school absence among grades K-12, and decreased likelihood of high school graduation and transition to post-secondary education. LAS treatment was associated with improved report card (score estimate −4.93 Treated, −6.19 Untreated) and provincial assessment exam scores (percentile rank estimate −9.20 Treated, −11.50 Untreated) among grades 9 to 12, reduced absences among grades K-12 (absence rate estimate −3.33 Treated, 7.96 Untreated), and increased likelihood of graduation (OR of failure to graduate 1.39 Treated, 2.22 Untreated) and transition to post-secondary education (OR of no transition 0.77 Treated, 1.42 Untreated; reference = No ADHD group). Conclusion: LAS pharmacotherapy is associated with improved academic performance, attendance, and likelihood of graduation and transition to post-secondary education.