APPENDICES. A systematic review and economic model of the ...

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312 Appendix 12 Study Intervention Participants Outcomes Core symptoms IOWA CTRS: inattention/overactivity Inclusion criteria No explicit inclusion criteria except DSM-III-R diagnosis Reference Pelham et al., 1993 79 Co-existent problems Rule-following behaviour (teachers) CO-CADD Observation Scheme: on-task behaviour, disruptive behaviour (trained observers) IOWA CTRS: oppositional/defiant Social validity ratings: normality, pleasantness (teachers) Diagnostic criteria DSM-III-R Arm 1 MPH alone and with non-drug intervention 0.3 mg/kg/dose (n = 27) or 0.15 mg/kg/dose (n = 4) administered twice daily (a.m., noon); mean 8.1 mg/dose; range 5–15 mg/dose; 1/2 weeks with BM intervention (Individual administering medication not reported) Source AHRQ Report Number Total = 31 (male = 31) No withdrawals reported Age 8.23 years (mean); 5.42–9.92 years (range) Setting USA (STP) Design Crossover trial Educational performance Individualised academic tasks: accuracy, productivity IQ 110.7 (mean) Psychological function Not reported Co-morbid disorders ODD: n = 10/31; CD: n = 15/31; learning achievement score discrepancies: n = 17/31; receiving help for learning or behavioural problems: n = 12/31 Arm 2 MPH alone and with non-drug intervention 0.6 mg/kg/dose (n = 27) or 0.3 mg/kg/dose (n = 4) administered twice daily (a.m., noon); mean 16.0 mg/dose; range 10–22.5 mg/dose; 1/2 weeks with BM intervention (Individual administering medication not reported) Duration Treatment programme: 8 weeks; Total treatment period: 6 weeks (2 weeks per treatment arm) Depression or anxiety Not reported Quality of life Not reported Adverse events Not reported Diagnostic subtypes Not reported Additional information Co-interventions: 12/31 were receiving part- or full-time services for learning or behaviour problems Additional outcomes Not reported Arm 3 Placebo alone and with non-drug intervention Administered twice daily (a.m. noon); 1/2 weeks with BM intervention (Individual administering medication not reported) Purpose To evaluate the separate and combined effects of BM and two doses of MPH compared with baseline (no BM and a placebo) on classroom behaviour and academic performance
Core symptoms Educational performance Quality of life Adverse events Not reported Not reported Individualised academic tasks: % accuracy With/without BM, mean (SD): MPH, 0.3: 92.1 (6.5)/90.7 (9.6) MPH, 0.6: 91.6 (7.2)/90.1 (8.0) Placebo: 87.0 (12.4)/88.4 (13.6) Effect BM: F(1,29) = 0.38, NS Effect MPH: F(2,58) = 0.63, NS IOWA CTRS: inattention/overactivity With/without BM, mean (SD): MPH 0.3: 2.1 (2.1)/2.0 (2.1) MPH 0.6: 1.5 (1.8)/1.7 (2.1) Placebo: 4.9 (3.3)/6.0 (4.3) Effect BM: F(1,29) = 3.36, NS Effect MPH: F(2,58) = 36.19, p < 0.0001 Individualised academic tasks: % productivity With/without BM, mean (SD): MPH, 0.3: 77.4 (21.0)/79.6 (19.7) MPH, 0.6: 81.2 (17.1)/81.1 (18.4) Placebo: 62.2 (26.3)/62.2 (28.8) Effect BM: F(1,29) = 0.00, NS Effect MPH: F(2,58) = 10.31, p < 0.001 Conclusions Authors’ conclusions: The authors concluded that BM and MPH separately improved the classroom behaviour of ADHD boys, although only MPH had a beneficial effect on the children’s academic performance. Further, the combination of the two treatments was more effective than BM alone but yielded limited improvement beyond that afforded by MPH alone © Queen’s Printer and Controller of HMSO 2006. All rights reserved. Reviewer’s comments: No comments noted Health Technology Assessment 2006; Vol. 10: No. 23 313
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Appendices A systematic review and
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