{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T19:46:58Z","timestamp":1792439218259,"version":"4.5.0"},"reference-count":17,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacoepidemiology and Drug"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To improve interpretation of long\u2010term ADHD medication treatment trajectories in Norway by examining sex\u2010 and age\u2010specific persistence, distinguishing within\u2010substance product switching from active\u2010ingredient (ATC substance) switching, and describing the medication and prescriber context of the last observed dispensation before non\u2010persistence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study used population\u2010based data from the Norwegian Prescription Database (NorPD) to identify 33\u2009706 incident users initiating ADHD medication in 2012\u20132016, defined using an individual\u2010specific 5\u2010year look\u2010back. Participants were followed for up to 5\u2009years until 2021. We estimated dispensing\u2010based persistence, defined non\u2010persistence as the first dispensing gap of \u2265\u2009396\u2009days\/13\u2009months, characterised switching as either within\u2010substance product switching or active\u2010ingredient (ATC substance) switching, and described the last dispensed medication and prescriber specialty recorded before non\u2010persistence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The cohort included 19\u2009898 men (59%) and 13\u2009808 women (41%); 97%\u201398% initiated methylphenidate. Five\u2010year persistence was 39% in men and 35% in women. During follow\u2010up, 41% had no switch and 26% had \u2265\u20094 switches. Among first switches, within\u2010substance product switching predominated (80.9% in men; 77.5% in women), while active\u2010ingredient switching was less common (19.1% and 22.5%, respectively). Among those who met the non\u2010persistence definition during follow\u2010up (62.4%), the last dispensed medication was methylphenidate (76%), atomoxetine\/guanfacine (12%), lisdexamfetamine (7%), and dexamphetamine (3%), respectively; the last prescriber specialty recorded on the last dispensation was a general practitioner for 51.9% and a specialist for 48.1%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In Norway, most incident ADHD medication users met a dispensing\u2010based definition of non\u2010persistence within 5\u2009years. Switching was frequent, but most first switches occurred within the same active substance rather than between substances, suggesting that many observed changes in dispensing data may reflect product substitution or formulation change rather than a true change in pharmacological strategy. These findings may improve interpretation of long\u2010term treatment trajectories.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pds.70486","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:44:45Z","timestamp":1791852285000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Long\u2010Term Treatment Patterns in Norwegian\n                    <scp>ADHD<\/scp>\n                    \u2010Medicine Users: A Cohort Register\u2010Based Study With 5\u2009Years of Follow\u2010Up, 2012\u20132021"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4960-1715","authenticated-orcid":false,"given":"Espen","family":"Anker","sequence":"first","affiliation":[{"name":"Klinikk Toppetasjen  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2020-6164","authenticated-orcid":false,"given":"Anne","family":"Halm\u00f8y","sequence":"additional","affiliation":[{"name":"Division of Psychiatry Haukeland University  Bergen Norway"},{"name":"Department of Clinical Medicine University\u00a0of\u00a0Bergen  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8392-3366","authenticated-orcid":false,"given":"Mats","family":"Fredriksen","sequence":"additional","affiliation":[{"name":"Division of Mental Health and Addiction Vestfold Hospital Trust  Tonsberg 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