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

44 TABLE 20
Clinical effectiveness
MPH high dose (>30 mg/day) versus non-drug intervention
Study Design Intervention – N Age Duration Core outcomes
(years) (weeks)
Administered two or more times daily
Pelham, 1993 79 C (3×) MPH (32 mg/day, b.d.) vs behavioural 5.4–9.9 6 Core: no hyp; IOWA CTRS: inattention/overactivity
modification intervention (STP, 8 weeks) – 31 QoL: not reported
AE: not reported
Klein, 1997 65 P MPH (1.55 mg/kg/day, b.d.) vs 6–12 12 Core: CTRS and CPRS: hyperactivity; Home Hyperactivity
behavioural intervention + parent Scale (parents)
and teacher education (4 weeks) – 86 QoL: CGI (teacher/mothers/psychiatrists)
AE: not reported
Kolko, 1999 69 C (4×) MPH (1.2 mg/kg/day, b.d.) vs behavioural 7–13 6 Core: no hyp; IOWA CTRS: inattention/overactivity
modification (6 weeks) – 22 QoL: not reported
AE: no details reported
C, crossover trial (number of crossovers); CGI, Clinical Global Improvement; CPRS, Conners’ Parent Rating Scale; CTRS, Conners’ Teacher Rating Scale; P, parallel trial; STP, Summer
Treatment Programme.
TABLE 21 Results for hyperactivity [MPH high dose (>30 mg/day) versus non-drug intervention]
Study Scale MPH high dose: mean (SD) Non-drug: mean (SD) p-Value (if reported) a
6–12 years
Klein, 1997 65 MD (95% CI)
CTRS (hyperactivity) 1.1 (0.4) 1.5 (0.6) 0.01 –0.60 (–0.76 to –0.44)
CPRS (hyperactivity) 0.7 (0.5) 0.8 (0.4) NS –0.20 (–0.32 to –0.08)
Home Hyperactivity Scale (parents) 2.1 (0.46) 2.4 (0.86) NS –0.60 (–0.92 to –0.28)
a Note that owing to the overall poor reporting of study methodology, the p-values should be interpreted with caution.
Lower scores represent a better behavioural outcome.
CPRS, Conners’ Parent Rating Scale; CTRS, Conners’ Teacher Rating Scale; NS, not significant; MD, mean difference.