- Title
- Attention-deficit/hyperactivity disorder (ADHD) in South Africa: diagnosis and treatment from childhood to adulthood
- Creator
- Munasur-Naidoo, Ashmitha Premchand
- Subject
- Attention-deficit hyperactivity disorder
- Date Issued
- 2020
- Date
- 2020
- Type
- Thesis
- Type
- Doctoral
- Type
- PhD
- Identifier
- http://hdl.handle.net/10948/46398
- Identifier
- vital:39603
- Description
- Background: Historically Attention-Deficit/hyperactivity disorder (ADHD) was, considered to be a condition that affected mainly children. Over a period of time, there has been a greater understanding to recognize that this condition is also present in the adult population. Globally, treatment for adults has been established as is evident from the various guidelines available. In South Africa, however,healthcare is split into the public and private sectors, which results in differences in the extent of diagnosis and treatment for adults with ADHD.Aim: The primary aim of the study was to evaluate ADHD in South Africa from childhood to adulthood and to determine to what extent adults are being diagnosed and treated.Method: This study comprised of two facets, namely, a drug utilization review and a questionnaire survey. The first part comprised of a retrospective drug utilization study evaluating the consumption and cost of medication used in the treatment of ADHD. The questionnaire was undertaken using a survey methodology amongst selected healthcare professionals in South Africa involved in the diagnosis and treatment of adult ADHD. The data generated from this study together with available guidelines was assessed and a proposed framework for the treatment and diagnosis of adult ADHD was developed for use in the South African public healthcare sector. Results: Based on the registered medication available to treat ADHD, the consumption of methylphenidate and atomoxetine in the private healthcare sector using the Intercontinental Marketing Service database from 2013 to 2016was established. Despite the controversy regarding stimulant medication, methylphenidate was shown to be the medication of choice in South Africa. The consumption of methylphenidate (95.85%) was higher when compared to atomoxetine (4.15%) in 2013 and very slight changes were observed in 2016 were the consumption was 96.40% and 3.60%, respectively. Similarly, over a four-year period, the spend on ADHD medication increased in 2013 to 2016 by 62.63%. Furthermore, the market share for ADHD is dominated by extended-release methylphenidate tablets (59.53%). The questionnaire survey amongst selected healthcare professionals in South Africa involved in the diagnosis and treatment of adult ADHDhighlighted the tools used for diagnosis, pharmacological and non-pharmacological treatment options, which treatment has been found to be most successful, difference in treatment between genders, incorporation of supplementation into the management of patients, difficulties experienced by patients and which co-morbid conditions were also prevalent with ADHD. Based on the data collated in this study and an evaluation of the available guidelines, a framework for treatment of adult patients in the public healthcare sector has been proposed for South Africa at a provincial and national level. Conclusion: In South Africa treatment for ADHD is increasing in the private healthcare sector. The cost and consumption of methylphenidate and atomoxetine has risen over a short period. The treatment of adults in the private sector has also garnered interest, however, the public sector has not yet published guidelines enabling access to diagnosis and treatment for these adult patients. Given the chronic, costly, and debilitating nature of this condition more needs to be done to assist those affected by it. Further studies in this area of neuropsychiatry in South Africa is required to enable access to diagnosis and treatment in the public healthcare sector.
- Format
- xxi, 216 leaves
- Format
- Publisher
- Nelson Mandela University
- Publisher
- Faculty of Health Science
- Language
- English
- Rights
- Nelson Mandela University
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | SOURCE1 | Munasur-Naidoo, AP 216840295 Thesis April 2020.pdf | 18 MB | Adobe Acrobat PDF | View Details Download |