Disparities in treatment initiation following diagnosis of attention-deficit/hyperactivity disorder: a systematic review.
Philip Wickham, Saima Orangzeb, Jacqueline M Cohen et al.
✦ AI-curated · Sources linked
In 30 seconds
This systematic review examined whether sociodemographic factors are associated with time to treatment initiation after ADHD diagnosis in children and adolescents. Twelve studies were included; heterogeneity precluded meta-analysis, so findings were synthesized narratively. Most studies assessing sex reported earlier treatment initiation among males than females, with effect estimates ranging from 1.02 (95% CI 0.82-1.26) to 1.36 (95% CI 1.21-1.54). Children from racial and ethnic minority groups, lower-income families, and rural areas generally experienced longer delays, while findings varied by region and showed no consistent differences by insurance type.
Key findings
- Most studies assessing sex found earlier treatment initiation among males; effect estimates ranged from 1.02 (95% CI 0.82-1.26) to 1.36 (95% CI 1.21-1.54).
- Children from racial and ethnic minority groups, lower-income families, and rural areas generally had longer delays in starting treatment.
- Findings varied by geographic region, and studies showed no consistent differences in treatment-initiation timing by insurance type.
- Twelve studies were included from 6,223 initially identified; heterogeneity prevented meta-analysis.
Why it matters
Timely treatment after ADHD diagnosis is relevant to children’s longer-term outcomes, yet the review indicates that delays may differ across sociodemographic groups. Recognising these patterns can help frame equitable access to care as an issue extending beyond diagnosis alone, while the variation across studies cautions against assuming that disparities are uniform across settings.
What to keep in mind
Only 12 studies were included, and heterogeneity prevented meta-analysis. Findings were synthesized narratively, and results varied across geographic regions.