Medication adherence and influencing factors in children and adolescents with attention deficit hyperactivity disorder (ADHD): a systematic review and meta-analysis.

Prior to the 1990s, most research forming the basis for clinical decision-making was conducted in only male subjects, with findings extrapolated to females and women. In 1993, the passing of the National Institutes of Health’s (NIH) Revitalization Act required inclusion of women and minorities in clinical studies. Progression toward better representation of women in clinical studies continued over the 1990s and early 2000s. Then, in 2014, the National Institutes of Health (NIH) announced that male and female cells must be balanced in animal research and built upon this premise in 2016 with the announcement that all grants funded by the agency must include sex as a biological variable in concept, experimental design, and evaluation. As health care advances toward a more personalized approach, emphasizing genomic, molecular, and cellular interactions that contribute to health and disease, it is crucial to acknowledge the significant influence of sex and gender on illness and health outcomes. Existing research has already demonstrated numerous differences in disease incidence, symptomology, morbidity, and mortality based on sex and gender. Despite these advancements, the translation of sex- and gender-based science into clinical practice remains inadequate, particularly as it pertains to the inclusion of sex- and gender-specific health (SHSH) topics into medical education for future physicians.