title: Cluster-randomized, controlled 12-month trial to evaluate the effect of a parental psychoeducation program on medication persistence in children with attention-deficit/hyperactivity disorder.
abstract: BACKGROUND
  This multicenter, cluster-randomized, nonblinded study evaluated the effect of parental psychoeducation on medication persistence among children and adolescents with newly diagnosed attention-deficit/hyperactivity disorder (ADHD).
  
  
  METHODS
  Patients received standard medication alone or medication plus a parental psychoeducation program, and were followed for 12 months. The primary endpoint was time to withdrawal or termination of medication due to any cause. Secondary endpoints included change in ADHD symptom severity, functional outcome, program satisfaction, and safety.
  
  
  RESULTS
  A total of 208 patients completed the study, which was terminated early because recruitment had ceased. At 12 months, there was no significant difference between the psychoeducation and control groups in the proportion of patients who discontinued pharmacologic treatment (13.2% versus 14.3%, respectively; size effect -0.3, P=0.34; hazard ratio 0.72, 95% confidence interval 0.36-1.43). Psychoeducation was associated with a significantly greater improvement in ADHD symptoms but not in functional outcome. Parental satisfaction with psychoeducation was high, and satisfaction with pharmacologic treatment was significantly greater in the psychoeducation group. There were no safety concerns.
  
  
  CONCLUSIONS
  No significant advantage for parental psychoeducation plus medication over medication alone in terms of time to medication withdrawal was observed. Psychoeducation had inconsistent but interesting effects on other outcomes.
authors: Medical Neurosciences, Lilly Research Laboratories Canada, Toronto, ON, Canada.
authors: Alonso
authors: A
authors: Montoya
authors: Child and Adolescent Mental Health Unit, Hospital Universitari Mutua de Terrassa, and Developmental Disorders Unit, Hospital Sant Joan de Déu, Barcelona, Spain.
authors: Amaia
authors: A
authors: Hervás
authors: Child and Adolescent Psychiatry Unit, Policlinica Gipuzkoa, San Sebastian, Spain.
authors: Joaquín
authors: J
authors: Fuentes
authors: Neuropediatric Unit, Hospital Son Llatzer, University of the Balearic Islands, Palma de Mallorca, Spain.
authors: Esther
authors: E
authors: Cardo
authors: Department of Clinical Research, Lilly Research Laboratories Spain, Alcobendas, Spain.
authors: Pepa
authors: P
authors: Polavieja
authors: Department of Psychiatry, Hospital Universitario Infanta Leonor, Madrid, Spain.
authors: Javier
authors: J
authors: Quintero
authors: Applied Psychology and Human Development, and Neurosciences and Mental Health Research Program, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada.
authors: Rosemary
authors: R
authors: Tannock
keywords: adjunctive psychoeducation; attention-deficit/hyperactivity disorder; medication persistence; parents; psychoeducation