Systematic review of quality of life and functional outcomes in randomized placebo-controlled studies of medications for attention-deficit/hyperactivity disorder
Autor: | Matthew G. Cottingham, Tobias Banaschewski, David Coghill, Alessandro Zuddas, Cesar Soutullo |
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Jazyk: | angličtina |
Rok vydání: | 2017 |
Předmět: |
Quality of life
Pediatrics medicine.medical_specialty MEDLINE Review Placebo law.invention 03 medical and health sciences 0302 clinical medicine Pharmacotherapy Randomized controlled trial law Developmental and Educational Psychology medicine Child and adolescent psychiatry Attention deficit hyperactivity disorder Humans Clinical significance Child Randomized Controlled Trials as Topic General Medicine medicine.disease humanities 030227 psychiatry Psychiatry and Mental health Attention-deficit/hyperactivity disorder Treatment Outcome Functional impairment Attention Deficit Disorder with Hyperactivity Child Preschool Pediatrics Perinatology and Child Health Systematic review Randomized clinical trials Psychology 030217 neurology & neurosurgery |
Zdroj: | European Child & Adolescent Psychiatry |
ISSN: | 1435-165X 1018-8827 |
Popis: | Children, adolescents and adults with attention-deficit/hyperactivity disorder (ADHD) experience functional impairment and poor health-related quality of life (HRQoL) in addition to symptoms of inattention/hyperactivity–impulsivity. To synthesize qualitatively the published evidence from randomized, double-blind, placebo-controlled trials of the effectiveness of pharmacotherapy on functional impairment or HRQoL in patients with ADHD, a systematic PubMed searching and screening strategy was designed to identify journal articles meeting pre-specified criteria. Post hoc analyses and meta-analyses were excluded. HRQoL outcomes, functional outcomes and the principal ADHD symptom-based outcome were extracted from included studies. An effect size of 0.5 versus placebo was used as a threshold for potential clinical relevance (unreported effect sizes were calculated when possible). Of 291 records screened, 35 articles describing 34 studies were included. HRQoL/functioning was usually self-rated in adults and proxy-rated in children/adolescents. Baseline data indicated substantial HRQoL deficits in children/adolescents. Placebo-adjusted effects of medication on ADHD symptoms, HRQoL and functioning, respectively, were statistically or nominally significant in 18/18, 10/12 and 7/9 studies in children/adolescents and 14/16, 9/11 and 9/10 studies in adults. Effect sizes were ≥0.5 versus placebo for symptoms, HRQoL and functioning, respectively, in 14/16, 7/9 and 4/8 studies in children/adolescents; and 6/12, 1/6 and 1/8 studies in adults. Effect sizes were typically larger for stimulants than for non-stimulants, for symptoms than for HRQoL/functioning, and for children/adolescents than for adults. The efficacy of ADHD medication extends beyond symptom control and may help reduce the related but distinct functional impairments and HRQoL deficits in patients with ADHD. Electronic supplementary material The online version of this article (doi:10.1007/s00787-017-0986-y) contains supplementary material, which is available to authorized users. |
Databáze: | OpenAIRE |
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