Relationship between symptom impairment and treatment outcome in children and adolescents with attention-deficit/hyperactivity disorder: a physician perspective

We evaluated the association between those symptoms/behaviours of attention-deficit/hyperactivity disorder (ADHD) that were present at diagnosis and outcomes of treatment in children and adolescents in six European countries. Physicians abstracted clinical records from patients (6–17 years) diagnose...

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Main Authors:	Setyawan, Juliana, Fridman, Moshe, Hodgkins, Paul, Quintero, Javier, Erder, M. Haim, Katić, Božena J., Harpin, Valerie
Format:	Online
Language:	English
Published:	Springer Vienna 2014
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4340973/

id	pubmed-4340973
recordtype	oai_dc
spelling	pubmed-43409732015-03-03 Relationship between symptom impairment and treatment outcome in children and adolescents with attention-deficit/hyperactivity disorder: a physician perspective Setyawan, Juliana Fridman, Moshe Hodgkins, Paul Quintero, Javier Erder, M. Haim Katić, Božena J. Harpin, Valerie Original Article We evaluated the association between those symptoms/behaviours of attention-deficit/hyperactivity disorder (ADHD) that were present at diagnosis and outcomes of treatment in children and adolescents in six European countries. Physicians abstracted clinical records from patients (6–17 years) diagnosed with ADHD between 2004 and 2007 and treated for ≥2 years. Physicians scored the severity of impairment for core ADHD symptoms and additional (non-core) ADHD symptoms/behaviours at diagnosis and estimated treatment adherence (defined as an estimated >80 % adherence on weekdays and >50 % adherence on weekends). Treatment modalities included pharmacological treatment, behavioural therapy, or both. Pharmacological treatment was further subclassified by medication class. The outcome, optimal treatment success (OTS), was defined as complete symptom control with high satisfaction with treatment. Multivariate logistic regression modelling examined the relationship between OTS and symptom impairment. Of 730 patients, 200 (27 %) achieved OTS. These patients were more likely to demonstrate lower impairment in non-core ADHD symptoms/behaviours and have fewer pre-existing comorbidities. They were also more likely to be adherent and engaged with treatment, with an explicit treatment goal to improve inattention/school performance. Neither core symptoms’ severity nor treatment types were associated with OTS. OTS rates were low, with patients having less impairment of non-core ADHD symptoms/behaviours and fewer comorbidities more likely to achieve OTS. Potentially modifiable factors affecting OTS were as follows: treatment adherence, treatment engagement, and a treatment goal to improve inattention/school performance. These data suggest that there may be opportunities to optimize current treatment use, and develop new treatment strategies to improve core and non-core ADHD symptoms/behaviours. Springer Vienna 2014-08-23 2015 /pmc/articles/PMC4340973/ /pubmed/25148781 http://dx.doi.org/10.1007/s12402-014-0143-0 Text en © The Author(s) 2014 Open AccessThis article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Setyawan, Juliana Fridman, Moshe Hodgkins, Paul Quintero, Javier Erder, M. Haim Katić, Božena J. Harpin, Valerie
spellingShingle	Setyawan, Juliana Fridman, Moshe Hodgkins, Paul Quintero, Javier Erder, M. Haim Katić, Božena J. Harpin, Valerie Relationship between symptom impairment and treatment outcome in children and adolescents with attention-deficit/hyperactivity disorder: a physician perspective
author_facet	Setyawan, Juliana Fridman, Moshe Hodgkins, Paul Quintero, Javier Erder, M. Haim Katić, Božena J. Harpin, Valerie
author_sort	Setyawan, Juliana
title	Relationship between symptom impairment and treatment outcome in children and adolescents with attention-deficit/hyperactivity disorder: a physician perspective
title_short	Relationship between symptom impairment and treatment outcome in children and adolescents with attention-deficit/hyperactivity disorder: a physician perspective
title_full	Relationship between symptom impairment and treatment outcome in children and adolescents with attention-deficit/hyperactivity disorder: a physician perspective
title_fullStr	Relationship between symptom impairment and treatment outcome in children and adolescents with attention-deficit/hyperactivity disorder: a physician perspective
title_full_unstemmed	Relationship between symptom impairment and treatment outcome in children and adolescents with attention-deficit/hyperactivity disorder: a physician perspective
title_sort	relationship between symptom impairment and treatment outcome in children and adolescents with attention-deficit/hyperactivity disorder: a physician perspective
description	We evaluated the association between those symptoms/behaviours of attention-deficit/hyperactivity disorder (ADHD) that were present at diagnosis and outcomes of treatment in children and adolescents in six European countries. Physicians abstracted clinical records from patients (6–17 years) diagnosed with ADHD between 2004 and 2007 and treated for ≥2 years. Physicians scored the severity of impairment for core ADHD symptoms and additional (non-core) ADHD symptoms/behaviours at diagnosis and estimated treatment adherence (defined as an estimated >80 % adherence on weekdays and >50 % adherence on weekends). Treatment modalities included pharmacological treatment, behavioural therapy, or both. Pharmacological treatment was further subclassified by medication class. The outcome, optimal treatment success (OTS), was defined as complete symptom control with high satisfaction with treatment. Multivariate logistic regression modelling examined the relationship between OTS and symptom impairment. Of 730 patients, 200 (27 %) achieved OTS. These patients were more likely to demonstrate lower impairment in non-core ADHD symptoms/behaviours and have fewer pre-existing comorbidities. They were also more likely to be adherent and engaged with treatment, with an explicit treatment goal to improve inattention/school performance. Neither core symptoms’ severity nor treatment types were associated with OTS. OTS rates were low, with patients having less impairment of non-core ADHD symptoms/behaviours and fewer comorbidities more likely to achieve OTS. Potentially modifiable factors affecting OTS were as follows: treatment adherence, treatment engagement, and a treatment goal to improve inattention/school performance. These data suggest that there may be opportunities to optimize current treatment use, and develop new treatment strategies to improve core and non-core ADHD symptoms/behaviours.
publisher	Springer Vienna
publishDate	2014
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4340973/
_version_	1613192706900623360

Relationship between symptom impairment and treatment outcome in children and adolescents with attention-deficit/hyperactivity disorder: a physician perspective

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