Treatment adherence and persistence in adult ADHD: Results from a twenty-four week controlled clinical trial with extended release methylphenidate - 14/06/14
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Abstract |
Purpose |
The aim of this analysis is to describe medication adherence, and treatment persistence, in adults with attention deficit/hyperactivity disorder (ADHD) treated for 24weeks with extended release methylphenidate (MPH-ER). Additionally, patient-, disorder- and treatment-related factors associated with adherence and persistence will be identified.
Method |
Post-hoc analysis of the active treatment group of a placebo-controlled, randomised, 24week trial with MPH-ER with univariate description and multiple logistic regression models and Hosmer and Lemeshow tests.
Results |
In the sample of 241 adults with ADHD (mean age of 35.2±10.1years), 9.4% of the patients were non-adherent, taking less than 80% of the dispensed medication. Factors associated with non-adherence included age<25 years, education level lower than secondary education, lacking family history of ADHD, lower ADHD baseline severity and lower self- and observer-rated medication efficacy. Lacking family history of ADHD, lower education level and lower self-rated medication efficacy, predicted non-adherence with a prediction accuracy of 16%. Seventeen percent of the patients discontinued early with most discontinuing within the first five weeks of the MPH-ER titration phase. Mean persistence in the discontinuing group was 63.4±49.4days. Factors associated with discontinuation included male gender, lower education level, lacking family history of ADHD and lower self- and observer-rated medication efficacy. Treatment non-response, male gender and lower education level predicted treatment discontinuation with a prediction accuracy of 22.7%.
Conclusion |
Male adults without relatives with ADHD, with lower educational level and lower self- and observer-rated medication efficacy, who are newly treated with MPH-ER, are at increased risk of non-adherence and treatment discontinuation. Patients are at increased risk of treatment discontinuation during the medication titration phase.
Le texte complet de cet article est disponible en PDF.Keywords : ADHD, Adults, Adherence, Persistence, Methylphenidate
Plan
Vol 29 - N° 5
P. 324-330 - juin 2014 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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