Impact of family structure on stimulant use among children with attention-deficithyperactivity disorder

Objective. To examine the impact of family structure on pharmacologic stimulant use among children with attention-deficithyperactivity disorder (ADHD). Data Source. Nationally representative, population-based sample of the National Health Interview Survey from 1997 to 2003 linked with drug event files from the Medical Expenditure Panel Survey from 1998 to 2005. Study Design. Stepwise multivariate logistic regression was used to examine the likelihood of stimulant use for each individual during 2 years of observation after adjustment for sociodemographic, health, and family characteristics. Stratified analyses were also conducted to examine whether family characteristics had different impacts within single-mother and dual-parent households. Principal Findings. Stimulant use varied based on children's sociodemographic and health characteristics. In multivariate analyses, associations between children's household structure, parental education, and stimulant use appeared to be mediated by children's access to care and health status. However, in full multivariate models, there remained a robust positive association between family size and stimulant use. Conclusions. These findings highlight the influence that nonclinical factors such as family size may have in mediating the use of pharmacologic therapies for children.