Telehealth providers aren’t more likely to prescribe ADHD drugs, study finds

More patients with attention deficit hyperactivity disorder are being prescribed medication, according to an Epic Research analysis from the spring.

There have been increases in the diagnosis of ADHD in all age groups, with bigger increases being seen in women, Epic found in the spring.

With that in mind, Epic researchers sought to answer another question: Are providers prescribing ADHD drugs more often via telehealth?

It appears that physicians seeing patients virtually are no more likely to order ADHD medications than doctors who are treating patients in person, Epic found in a recent analysis.

For both telehealth and in-person visits, providers prescribed ADHD drugs within 30 days of an initial visit about 60% of the time, Epic said. The results were released June 27.

In most cases, the initial ADHD prescriptions were for stimulant medications. In telehealth appointments, 84% of the initial prescriptions were for stimulants, compared to 87% for providers seeing patients in person.

Epic researchers examined more than 205,000 appointments for ADHD and more than 933,000 visits for anxiety between Jan. 1, 2020 through March 31, 2023.

ADHD patients were more likely to get a prescription after an initial visit than those seeing providers for anxiety. Providers prescribed medication for around 50% of anxiety visits, Epic said. Researchers said they compared anxiety visits with ADHD appointments because providers typically don’t prescribe stimulants for anxiety issues.

It’s worth noting that Epic conducted its analysis of providers who treat patients in person and remotely. Epic didn’t examine prescription trends among providers who only offer services via telehealth.

Epic’s researchers said they wanted to examine ADHD medication trends in telehealth as federal authorities have weighed the question of restricting the remote prescription of some controlled substances.

Some telehealth advocates have pressed the Drug Enforcement Administration to continue allowing the prescription of those drugs via telehealth, noting that changes could hurt access for some patients with mental health issues.

The federal government eased remote prescriptions of some drugs used in behavioral health during the COVID-19 pandemic. Some of those flexibilities were tied to the federal designation of the public health emergency, which ended in May.

After healthcare advocacy groups and thousands of patients spoke out, the DEA said it would extend telehealth flexibilities for the remote prescription of controlled substances until at least November 11, 2023. If a patient and a practitioner have established a telemedicine relationship on or before Nov. 11, 2023, the flexibilities will be allowed to continue until November 11, 2024, federal officials said.

Under an earlier DEA proposal, doctors would have needed to see a patient in person before prescribing some drugs such as Adderall, which is used to treat ADHD, along with Vicodin and OxyContin. Patients could then get refills via virtual visits.

For now, providers can continue to fill prescriptions remotely.

The DEA has said it wants to strike a balance between improved access and safety. DEA Administrator Anne Milgram said in February that the agency wanted “guardrails that prevent the online overprescribing of controlled medications that can cause harm.”

Some healthcare advocates say they don’t want to see added restrictions that would make it harder for patients to receive the treatment they need.