title: Treatment outcomes after methylphenidate in adults with attention-deficit/hyperactivity disorder treated with lisdexamfetamine dimesylate or atomoxetine.
abstract: OBJECTIVE
  To compare treatment adherence, discontinuation, add-on, and daily average consumption (DACON) among adults with attention-deficit/hyperactivity disorder receiving second-line lisdexamfetamine dimesylate (LDX) or atomoxetine (ATX), following methylphenidate.
  
  
  METHODS
  A retrospective cohort study using US commercial claims databases (Q2/2009-Q3/2013).
  
  
  RESULTS
  At month 12, the LDX cohort (N=2,718) had a higher adherence level (proportion of days covered: 0.48 versus 0.30, P<0.001) and was less likely to discontinue (Kaplan-Meier estimate: 63% versus 85%, P<0.001) than the ATX cohort (N=674). There were no statistical differences in treatment add-on rates between cohorts (Kaplan-Meier estimate: 26% versus 25%, P=0.297). The LDX cohort had a lower DACON (1.10 versus 1.31, P<0.001) and was less likely to have a DACON >1 (adjusted odds ratio: 0.20, 95% confidence interval: 0.15-0.25, P<0.001) than the ATX cohort.
  
  
  CONCLUSIONS
  Adults with attention-deficit/hyperactivity disorder treated with LDX following methylphenidate had a higher treatment adherence and lower discontinuation and DACON relative to those treated with ATX following methylphenidate.
authors.affiliation: Global HEOR and Epidemiology, Shire, Zählerweg, Zug, Switzerland.
authors.forename: Alain
authors.initials: A
authors.lastname: Joseph
authors.affiliation: Analysis Group, Inc., Montreal, Quebec, Canada.
authors.forename: Martin
authors.initials: M
authors.lastname: Cloutier
authors.affiliation: Analysis Group, Inc., Montreal, Quebec, Canada.
authors.forename: Annie
authors.initials: A
authors.lastname: Guérin
authors.affiliation: Analysis Group, Inc., Montreal, Quebec, Canada.
authors.forename: Roy
authors.initials: R
authors.lastname: Nitulescu
authors.affiliation: Global HEOR and Epidemiology, Shire, Wayne, PA, USA.
authors.forename: Vanja
authors.initials: V
authors.lastname: Sikirica
keywords: ADHD; adherence; adult; atomoxetine; lisdexamfetamine dimesylate