title: The impact of the withdrawal of Adderall XR (long-acting mixed amphetamine salts) from the Canadian market on paediatric patients and their families.
abstract: BACKGROUND
  Adderall XR (Shire BioChem Inc, Canada), a medication used to treat attention deficit hyperactivity disorder, was withdrawn from the Canadian market in February 2005 due to concerns of possible cardiotoxicity and cerebral vascular events among a small number of individuals who had taken the medication.
  
  
  OBJECTIVE
  The primary objective of the present study was to investigate the degree to which the physician's relationship with the families of the patients to whom the medication was prescribed was affected by the withdrawal of Adderall XR from the Canadian market. The study sought to explore the perceptions of caregivers of patients who took Adderall XR to the drug recall. As a secondary objective, the study also assessed the differences in perception of caregivers toward physicians compared with their perception of other agencies involved with the recall.
  
  
  METHODS
  Questionnaires were sent to the caregivers of 123 patients who had been taking the drug at the time of the withdrawal.
  
  
  CONCLUSIONS
  Of the 53 (43%) completed questionnaires, 89% of respondents indicated that they were concerned when informed of the withdrawal, while 58% indicated that they were frightened. Despite the concerns, only a modest degree of anger was expressed. Thirty per cent of respondents reported anger directed at Health Canada, 24% reported anger directed at the manufacturer, while no caregiver reported anger directed at their physician. Only three families (5.7%) indicated a decrease in confidence in the physician following the event. Fifty-eight per cent indicated a willingness to resume taking Adderall XR, if it was deemed safe by Health Canada. These results offer insight into patient and family perspectives following an unexpected medication recall. While caregivers were generally concerned and often frightened by this event, the present data do not suggest that the parent-physician relationship was greatly affected.
authors.affiliation: Schulich School of Medicine, University of Western Ontario.
authors.forename: Anita
authors.initials: A
authors.lastname: Cheng
authors.forename: Gary A
authors.initials: GA
authors.lastname: Tithecott
authors.forename: Wendy E
authors.initials: WE
authors.lastname: Edwards
authors.forename: Ian G
authors.initials: IG
authors.lastname: Johnston