title: The impact of adjunctive guanfacine extended release on stimulant adherence in children/adolescents with attention-deficit/hyperactivity disorder.
abstract: OBJECTIVE
  To assess stimulant adherence among children/adolescents with attention-deficit/hyperactivity disorder (ADHD) augmenting stimulants with guanfacine extended-release (GXR).
  
  
  METHODS
  Inclusion criteria: 6-17 years, ≥1 ADHD diagnosis, ≥1 long-acting and/or short-acting stimulant with GXR augmentation. Modified medication possession ratio (mMPR; days medication available/days in period, excluding medication holidays) was assessed; mMPR <0.80 nonadherent. Regression models assessed change in mMPR adjusting for demographic and clinical characteristics.
  
  
  RESULTS
  Among patients nonadherent to stimulants pre-augmentation (n = 165), unadjusted mean (SD) pre- and post-stimulant mMPRs were 0.68 (0.11) and 0.87 (0.16). Adjusted mean change in mMPR was 0.20 for long-acting versus 0.18 for short-acting stimulants (p = 0.34).
  
  
  CONCLUSIONS
  Among patients nonadherent to stimulants, GXR augmentation was associated with increased stimulant adherence.
authors.affiliation: RTI Health Solutions, 3040 Cornwallis Road, Post Office Box 12194, Research Triangle Park, NC 27709, USA.
authors.forename: Juliana
authors.initials: J
authors.lastname: Meyers
authors.affiliation: Shire, 725 Chesterbrook Boulevard, Wayne, PA 19087, USA.
authors.forename: Kavita
authors.initials: K
authors.lastname: Gajria
authors.affiliation: RTI Health Solutions, 3040 Cornwallis Road, Post Office Box 12194, Research Triangle Park, NC 27709, USA.
authors.forename: Sean D
authors.initials: SD
authors.lastname: Candrilli
authors.affiliation: AMF Consulting, 846 S Citrus Avenue, Los Angeles, CA 90036, USA.
authors.forename: Moshe
authors.initials: M
authors.lastname: Fridman
authors.affiliation: Shire, 725 Chesterbrook Boulevard, Wayne, PA 19087, USA.
authors.forename: Vanja
authors.initials: V
authors.lastname: Sikirica
mesh_terms: D000293:Adolescent; D058647:Adrenergic alpha-2 Receptor Agonists / Q000008:administration & dosage* / Q000191:economics; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000191:economics; D000697:Central Nervous System Stimulants / Q000008:administration & dosage* / Q000191:economics; D002648:Child; D003365:Costs and Cost Analysis; D003692:Delayed-Action Preparations; D004359:Drug Therapy, Combination; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D016316:Guanfacine / Q000008:administration & dosage* / Q000191:economics; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D055118:Medication Adherence; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D012189:Retrospective Studies
chemical_list: D058647:Adrenergic alpha-2 Receptor Agonists; D000697:Central Nervous System Stimulants; D003692:Delayed-Action Preparations; D016316:Guanfacine
keywords: adherence; comparative effectiveness research; pediatrics