| Computer-assisted management of attention-deficit/hyperactivity disorder. | |
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MedLine Citation:
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PMID: 21669891 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Medication management of attention-deficit/hyperactivity disorder (ADHD) is often suboptimal. We examined whether (1) brief physician training plus computer-assisted medication management led to greater reduction in ADHD symptoms and (2) adherence to the recommended titration protocol produced greater symptomatic improvement. METHODS: A randomized medication trial was conducted that included 24 pediatric practices. Children who met criteria for ADHD were randomly assigned by practice to treatment-as-usual or a specialized care group in which physicians received 2 hours of didactic training on medication management of ADHD plus training on a software program to assist in monitoring improvement. Parent and teacher reports were obtained before treatment and 4, 9, and 12 months after starting medication. RESULTS: Children in both specialized care and treatment-as-usual groups improved on the ADHD Rating Scales and SNAP-IV, but there were no group differences in improvement rates. Brief physician training alone did not produce improvements. When recommended titration procedures were followed, however, outcomes were better for total and inattentive ADHD symptoms on both the ADHD Rating Scales and SNAP-IV parent and teacher scales. Results were not attributable to discontinuation because of adverse effects or failure to find an effective medication dose. CONCLUSIONS: Brief physician training alone did not lead to reductions in ADHD symptoms, but adherence to a protocol that involved titration until the child's symptoms were in the average range and had shown a reliable change led to better symptom reduction. Computer-assisted medication management can contribute to better treatment outcomes in primary care medication treatment of ADHD. |
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Authors:
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John V Lavigne; Mina K Dulcan; Susan A LeBailly; Helen J Binns; Thomas K Cummins; Poonam Jha |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural Date: 2011-06-13 |
Journal Detail:
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Title: Pediatrics Volume: 128 ISSN: 1098-4275 ISO Abbreviation: Pediatrics Publication Date: 2011 Jul |
Date Detail:
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Created Date: 2011-07-04 Completed Date: 2011-09-01 Revised Date: 2011-11-23 |
Medline Journal Info:
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Nlm Unique ID: 0376422 Medline TA: Pediatrics Country: United States |
Other Details:
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Languages: eng Pagination: e46-53 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2011 by the American Academy of Pediatrics. |
Affiliation:
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Department of Child and Adolescent Psychiatry (#10), Children's Memorial Hospital, 2300 Children's Plaza, Chicago, IL 60614, USA. jlavigne@childrensmemorial.org |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Attention Deficit Disorder with Hyperactivity
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drug therapy* Child Child, Preschool Female Humans Male Software Therapy, Computer-Assisted* / education |
| Grant Support | |
ID/Acronym/Agency:
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R01 MH 066866/MH/NIMH NIH HHS |
| Comments/Corrections | |
Comment In:
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Evid Based Ment Health. 2011 Nov;14(4):113
[PMID:
22009241
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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