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

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Appendix 12
Core symptoms Educational performance Quality of life Adverse events
Barkley SERS 50
1. Many symptoms commonly considered to
be side effects of stimulant medication were
present at baseline
2. DEX was associated with a significantly
greater severity of side-effects than MPH,
particularly negative emotional side-effects
(e.g. irritability, tearfulness, anxiety) 143
Not reported Parental Global Perceptions
Questionnaire: overall perceptions
MPH: 72.6%
DEX: 68.8%
p = 0.60
CPRS-R: composite hyperactivity index
Baseline: 84.63 (10.19)
MPH: 64.28 (13.46)
DEX: 64.89 (13.74)
Difference in treatment effect (MPH – DEX, 95%
CI): 1.03 (–2.03 to 4.10), p = 0.51
Global ratings of response:
Total side-effects:
Mean number (SD):
Baseline: 8.19 (3.97); DEX: 7.64 (3.83); MPH:
7.19 (3.82)
F = 3.72; p = 0.03; baseline vs MPH pairwise
contrast also significant (p < 0.01)
CPRS-R: impulsive-hyperactive factor
Baseline: 73.46 (9.85)
MPH: 57.39 (10.53)
DEX: 57.33 (11.22)
Difference in treatment effect (MPH – DEX, 95%
CI): 0.21 (–2.18 to 2.61), p = 0.87
Mean severity (of those reported) (SD):
Baseline: 4.08 (1.56); DEX: 3.73 (1.68); MPH:
3.24 (1.46)
F = 15.98; p < 0.01; baseline vs MPH and
DEX vs MPH pairwise contrasts also significant
(p < 0.01)
64/102 children on MPH rated
themselves as responders
38/102 children on MPH rated
themselves as non-responders
75/102 parents of children on
MPH rated their child as a
responder
27/102 parents of children on
MPH rated their child as a nonresponder
There was a significant difference
between parent and child ratings:
2 = 3.70, p = 0.05. This was a
discrepancy of 26.5%
CTRS-R: hyperactivity index
Baseline: 71.46 (11.45)
MPH: 56.14 (10.17)
DEX: 58.76 (10.57)
Difference in treatment effect (MPH – DEX,
95% CI): 2.60 (0.69 to 4.51), p < 0.01
Individual side-effects:
Prevalence: no (%) (significant difference in
proportions using 1 ):
Trouble sleeping: DEX: 88 (70); MPH: 79
(640)
Poor appetite: DEX: 74 (59); MPH: 69 (56)
Irritable: DEX: 102 (82); MPH: 100 (80)
Proneness to crying: DEX: 95 (76); MPH: 89
(71)
Anxiousness: DEX: 85 (68); MPH: 76 (61)
Sadness/unhappiness: DEX: 74 (59); MPH: 69
(56)
Headaches: DEX: 38 (30); MPH: 30 (24)
Stomach aches: DEX: 50 (40); MPH: 40 (32)
Nightmares: DEX: 35 (28); MPH: 26 (21)
Daydreams: DEX: 78 (62); MPH: 77 (62)
56/102 children on DEX rated
themselves as responders
48/102 children on DEX rated
themselves as non-responders
72/102 parents of children on DEX
rated their child as a responder
29/102 parents of children on DEX
rated their child as a nonresponder
There was a significant difference
between parent and child ratings:
2 = 6.25, p = 0.01. This was a
discrepancy of 35.6%
CTRS-R: hyperactivity factor
Baseline: 71.26 (13.24)
MPH: 56.20 (11.02)
DEX: 58.88 (11.08)
Difference in treatment effect (MPH – DEX,
95% CI): 2.78 (0.70 to 4.86), p < 0.01
CTRS-R: inattentive-passive factor
Baseline: 64.87 (8.80)
MPH: 54.09 (7.61)
DEX: 55.69 (8.90)
Difference in treatment effect (MPH – DEX,
95% CI) 1.61 (0.30, 2.92), p = 0.02
Parental Global Perceptions Questionnaire:
concentration
MPH: 74.2%
DEX: 70.4%
p = 0.59
continued