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

50 TABLE 26
Clinical effectiveness
MPH high dose (>30 mg/day) plus non-drug intervention versus non-drug intervention
Study Design Intervention – N Age Duration Core outcomes
(years) (weeks)
Administered two or more times daily
Elia, 1991 51 C (3×) MPH (25–90 mg/day, b.d.) vs behaviour 6–12 9 Core: results presented in graphs only
modification + diet (9 weeks) – 48 QoL: CGI (physician); C-GAS
AE: STESS (physician, parents)
Children’s Psychiatric Rating Scale: nervous mannerisms,
obsessive thinking
Pelham, 1993 79 C (3×) MPH (32 mg/day, b.d.) vs behavioural 5.4–9.9 8 Core: no hyp; IOWA CTRS: inattention/overactivity
modification (STP, 8 weeks) – 31 QoL: not reported
AE: not reported
Schachar, 1997 86 and P MPH (31.4 mg/day, b.d.) vs parent training 6–12 4 months Core: IOWA-C: hyperactivity (parent); IOWA-C:
Diamond, 1999 87 or parent support (4 months) – 91 hyperactivity–inattentiveness (teacher);
TIP: hyperactivity–impulsiveness (teacher and parent)
QoL: not reported
AE: Barkley 10-point scale: physiological, affective, overfocus,
tics (parents, teachers)
Klein, 1997 65 P MPH (1.48 mg/kg/day, b.d.?) vs BI + parent 6–12 12 Core: CTRS/CPRS: hyperactivity; Home Hyperactivity Scale
and teacher education (4 weeks) – 86 (parents)
QoL: CGI (teacher/mothers/psychiatrists)
AE: not reported
Smith, 1998 88 C (4×) MPH (50 mg/day, t.d.s.) vs behavioural 12–17 8 Core: no hyp; IOWA CTRS: inattention/overactivity
treatment (STP, 8 weeks) – 49 QoL: not reported
AE: side-effects rating from 0 (not troubling) to 3 (severe)
MPH (75 mg/day MPH) behavioural (counsellor, parents)
treatment (STP, 8 weeks) – 49
C (4×) MPH (1.2 mg/kg/day, b.d.) vs behaviour 7–13 6 Core: no hyp; IOWA CTRS: inattention/overactivity
modification (STP, 3 weeks) – 22 QoL: not reported
AE: SSERS
Kolko, 1999 69
Pelham, 1999 80 C (5×) MPH (35 mg/day, b.d.) – 26 5.8–12.7 6 Core: no hyp; IOWA-C: inattention/overactivity (teachers
and parents)
QoL: not reported
AE: Side Effects Checklist (teachers, counsellors, parents)
C, crossover trial (number of crossovers); C-GAS, Children’s Global Assessment Scale; CGI, Clinical Global Impression; CPRS, Conners’ Parent Rating Scale; CTRS, Conners’ Teacher
Rating Scale; IOWA-C, IOWA Conners’ Rating Scale; P, parallel trial; SSERS, Stimulant Drug Side Effects Rating Scale; TIP, Telephone Interview Probe.