Unpacking medication choices: Key factors influencing treatment decisions in children with newly diagnosed attention deficit hyperactivity disorder.

Background: Following a diagnosis of Attention-deficit/hyperactivity disorder (ADHD) many children require immediate use of pharmacological agents for symptom control, while for some children a trial of non-pharmacological management may be warranted initially. Aim: To study and identify the clinical and socio-economic factors associated with immediate use of pharmacotherapy versus non pharmacological management in children with newly diagnosed ADHD. Methods: A retrospective cross sectional study design using chart review was conducted in child and adolescent psychiatry services of a tertiary care hospital. The medical records between 2018 and 2020 were reviewed. The socio-demographic factors, symptom profiles and comorbidities were recorded. Descriptive statistics and Binary Logistic regression analyses were calculated for factors associated with use versus non-use of pharmacotherapy. Results: 187 patients screened positive for ADHD at the walk-in clinic and after detailed assessments, 101 were diagnosed with ADHD. With every one-point increase in Vanderbilt ADHD Parent Rating Scale (VADPRS) severity score, there is 1.2 times [ Conclusion: Pharmacotherapy for ADHD at initial diagnosis is strongly predicted by the severity of ADHD and other socio-economic variable that may require equal attention in the coming years.