Impact of COVID-19 pandemic policies on ADHD medication prescriptions among children and adolescents in Portugal

This study aims to analyse the prescription of medication for attention-deficit/hyperactivity disorder (ADHD) in children and adolescents, by age group and gender, before and during the COVID-19 pandemic, as well as the impact of government policies during this period. This study was a retrospective cohort analysis using data from the Portuguese national prescription database and included all children and adolescents aged 5-19 years. We conducted an interrupted time series analysis, modelled using a seasonal autoregressive integrated moving average (SARIMA) approach, to evaluate the impact on prescription medications while considering two intervention points resulting from government policies: March 2020, marking the start of strict anti-pandemic measures, and May 2021, marking the beginning of their easing. Following the start of strict anti-pandemic measures, from March 2020 to May 2021, a 9% lower prescription rate than expected was observed, while from June 2021 to December 2023, the prescription rate was greater than expected (+ 32%, with a peak of + 41% in children 5-9 years old) and more pronounced in girls. CONCLUSIONS: These findings highlight the complex impact of the pandemic on different age groups and between genders on the prescription of ADHD medicines. WHAT IS KNOWN: • ADHD medications are considered effective and have been increasingly prescribed to children and adolescents in recent years. WHAT IS NEW: • Following the COVID-19 pandemic, the increase in ADHD medication prescriptions exceeded expected trends. • Stratification by age group and gender revealed gender differences, with a more pronounced rise in prescriptions observed among girls.