Aug 17, 2023 - Health

Telehealth didn't drive up ADHD prescriptions at large health centers: study

Illustration of a magnifying glass inspecting a pill

Illustration: Eniola Odetunde/Axios

While the surge in prescriptions for ADHD drugs during the pandemic has often been attributed to expanded telehealth access, new research finds there has been little difference in prescribing rates for in-person or virtual care at large health centers since 2020.

Why it matters: There's been an ongoing debate about whether the explosion in telehealth enabled over-prescribing of ADHD medications like Adderall amid a prolonged drug shortage that's disrupted patient care.

What they found: Epic Research analyzed more than 1 million initial patient visits for ADHD and anxiety from more than 200 large health systems to compare potential differences in prescribing rates.

  • Between the pandemic's first year and March 2023, about 60% of visits for both virtual and in-person care resulted in a prescription for an ADHD medication (both stimulants and non-stimulants) within 30 days of initial diagnosis.
  • While telehealth visits remained more popular than in-person visits during the pandemic, there was not an observable, significant difference in prescribing rates by visit type.

Of note: Epic's analysis was limited to their customers, who are large health systems that use the electronic health record system across many locations, so it doesn't account for telehealth-only providers, for instance.

What they're saying: Shabana Khan, director of child and adolescent telepsychiatry at NYU Langone, said recent data shows that increased access to telehealth hasn't translated to over-diagnosing in younger patients. That's been the same experience for her psychiatry practice.

  • "We've seen an increase in telehealth because of flexibility at the federal and state level, but there are mechanisms in place to make sure there's legitimate practice of medicine," said Khan, who wasn't involved in the Epic Research.

Yes, but: Prescriptions for adults increased by more than 10% during the first year of the pandemic, per the Centers for Disease Control and Prevention.

  • Earlier this month, federal drug regulators said the stimulant shortages were attributed to an increase in prescribing and the failure of the drug manufacturers to hit production quotas.

What's next: The ADHD drug shortage continues as kids are returning to school.

  • Some providers are running out of options for their patients, as they struggle to keep up with which stimulants are cycling in and out of shortage. Some patients are simply going without their medication entirely.
  • Providers don't currently have a clear view into which pharmacies have stimulants in stock, Khan said, meaning patients often are left to hunt around for available medications.

Related: Biden admin seeks to limit telehealth prescriptions for some drugs

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