Effect of methylphenidate formulation for attention deficit hyperactivity disorder on patterns and outcomes of treatment.
OBJECTIVE
The aim of this study was to assess whether once-daily Concerta extended-release (XR) methylphenidate (MPH) is associated with: (1) better compliance; (2) decreased likelihood of accidents/injuries; and (3) lower health-care resource use over a 1-year period than 3-times-daily immediate-release (IR) MPH in children with attention deficit hyperactivity disorder (ADHD).


METHODS
Multivariate regression analyses were performed using an administrative database. Inclusion criteria were: (1) an age of 6-12 years at the date of first prescription for XR/IR MPH (index date); (2) patient-level data available for least 6 months before and 12 months after the index date; (3) no ADHD medications in the 6-month prior period; and (4) no XR MPH use by the IR MPH group.


RESULTS
IR MPH: n=344, mean age 9.55 years, 76% male; XR MPH: n=1431, mean age 9.78 years, 75% male. XR MPH patients were less likely to discontinue, less likely to switch, and more likely to persist (i.e., no gaps >14 days) with therapy (p <0.0001). Children receiving XR MPH were less likely to experience an accident or injury (OR=0.58, 95% CI 0.353-0.945). Use of XR MPH was associated with significantly fewer emergency room visits and general practitioner visits per patient, on average, over 1 year.


CONCLUSIONS
These data support the use of XR MPH with its simplified dosing regimen for children with ADHD.
Lage
Maureen
M
HealthMetrics Outcomes Research, Groton, Connecticut, USA.
Hwang
Pieway
P
D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000008:administration & dosage*; D002648:Child; D016208:Databases, Factual; D003692:Delayed-Action Preparations; D004334:Drug Administration Schedule; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000008:administration & dosage*; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000517:prevention & control*
D000697:Central Nervous System Stimulants; D003692:Delayed-Action Preparations; D008774:Methylphenidate