title: An observational study of once-daily modified-release methylphenidate in ADHD: quality of life, satisfaction with treatment and adherence.
abstract: Attention deficit hyperactivity disorder (ADHD) impacts significantly on the quality of life (QoL) of patients and their families. Choice of therapy is increasingly influenced by treatment satisfaction and patient preference, with once-daily modified-release methylphenidate (MPH-MR) formulations offering clear benefits compared with immediate-release (IR) dosage forms. The effects of MPH-MR on QoL in ADHD have not been widely investigated and need more clarity in practice. The open-label OBSEER study evaluated the effectiveness and tolerability of Equasym XL(®), a MPH-MR formulation, in routine practice. Children and adolescents (aged 6-17 years) with ADHD and attending school were included if Equasym XL(®) treatment was planned by the treating physician. Physicians, parents and patients completed questionnaires assessing QoL (KINDL; parent, child or adolescent versions), satisfaction with medication, adherence and treatment tolerability at baseline (Visit 1), 1-3 weeks (Visit 2) and 6-12 weeks (Visit 3) over a maximum 3-month observation period. Data from 822 consecutively referred patients were analysed. QoL and medication satisfaction increased from Visit 1 to Visit 3, with both patients and parents rating therapy with Equasym XL(®) as better than previous drug therapy. KINDL total score effect sizes were 0.67 (parents' ratings), 0.52 (children's ratings) and 0.51 (adolescents' ratings; all p < 0.001). All KINDL subscores also increased: both parents and patients had the greatest improvement for school. Adherence to Equasym XL(®) was frequently rated as superior to prior treatment, particularly compared with MPH-IR repeated dosing. Treatment was generally well tolerated; approximately 3% of the patients discontinued treatment due to adverse events. Equasym XL(®) improved QoL compared with prior therapy, and resulted in good medication satisfaction and adherence in drug-naïve and previously treated patients.
authors: Department of Child and Adolescent Psychiatry, University of Göttingen, Von-Siebold-Str. 5, 37075, Göttingen, Germany. arothen@gwdg.de
authors: Aribert
authors: A
authors: Rothenberger
authors: Andreas
authors: A
authors: Becker
authors: Dieter
authors: D
authors: Breuer
authors: Manfred
authors: M
authors: Döpfner
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000284:Administration, Oral; D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000523:psychology; D000697:Central Nervous System Stimulants / Q000008:administration & dosage*; D002648:Child; D003692:Delayed-Action Preparations; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005858:Germany; D006801:Humans; D055118:Medication Adherence; D008774:Methylphenidate / Q000008:administration & dosage*; D011597:Psychomotor Performance / Q000187:drug effects; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000697:Central Nervous System Stimulants; D003692:Delayed-Action Preparations; D008774:Methylphenidate