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首页> 外文期刊>The journal of clinical psychiatry >National Survey of Adherence, Efficacy, and Side Effects of Methylphenidate in Children With Attention-Deficit/Hyperactivity Disorder in Taiwan.
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National Survey of Adherence, Efficacy, and Side Effects of Methylphenidate in Children With Attention-Deficit/Hyperactivity Disorder in Taiwan.

机译：台湾对注意力缺陷/多动症儿童的哌醋甲酯依从性，功效和副作用的国家调查。

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OBJECTIVES: To identify the determinants of adherence to immediate-release (IR) methylphenidate in children and adolescents with attention-deficit/hyperactivity disorder (ADHD); to examine the impact of adherence on ADHD-related symptoms; and to compare the efficacy, adherence, and side effects of IR methylphenidate and osmotic release oral system (OROS) methylphenidate. METHOD: This national survey, involving 12 hospitals, consisted of 2 phases of assessment. Treatment adherence in 240 (39.5%) of the 607 children aged 5 to 16 years with a clinical diagnosis of DSM-IV ADHD enrolled in the study was poor (defined as missing >/= 1 dose of ADHD medication a day and on 2 days or more during school days). Children with poor adherence at phase 1 were able to switch to OROS methylphenidate, while adherents remained on the IR variant. We reassessed 124 poor adherents who switched to OROS methylphenidate. The global ADHD severity, parent-child interaction, classroom behavior, academic performance, and side effects of the child subjects were evaluated by investigators. Parents completed the rating scales about the ADHD-related symptoms. The study began in April 2005 and was completed in February 2006. RESULTS: Determinants for poor adherence included older age, later onset of ADHD, family history of ADHD, higher paternal education level, and multi-dose administration. Mental retardation and treatment at medical centers were inversely related to poor adherence. Overall, poor adherence was associated with more severe ADHD-related symptoms by comparison to good adherence. Similar side effect profile, superior adherence, and improved efficacy were demonstrated in intra-individual comparison of the OROS and IR methylphenidate forms. CONCLUSION: Given that poor adherence to medication may be an important reason for suboptimal outcome in ADHD treatment, physicians should ensure adherence with therapy before adjusting dosage or switching medication. TRIAL REGISTRATION: clinicaltrials.gov Identifier NCT00460720.
机译：目的：确定引起注意力缺乏/多动症（ADHD）的儿童和青少年对速释（IR）哌醋甲酯依从性的决定因素;检查坚持对多动症相关症状的影响;并比较IR哌醋甲酯和渗透释放口服系统（OROS）哌醋甲酯的疗效，依从性和副作用。方法：这项全国性调查涉及12家医院，包括2个评估阶段。纳入研究的607名5至16岁临床诊断为DSM-IV ADHD的儿童中，有240名（39.5％）的治疗依从性较差（定义为每天和第2天每天丢失// = 1剂量的ADHD药物）或更多在上学期间）。在第1阶段依从性差的儿童能够改用OROS哌醋甲酯，而依从性仍保留在IR变体上。我们重新评估了124位贫困者，他们改用OROS哌醋甲酯。研究者评估了全球多动症严重程度，亲子互动，课堂行为，学业成绩和儿童受试者的副作用。父母完成了有关多动症相关症状的评定量表。该研究于2005年4月开始，并于2006年2月完成。结果：依从性差的决定因素包括年龄较大，ADHD发病较晚，ADHD家族史，较高的父亲教育水平和多剂量给药。医疗中心的智力低下和治疗与依从性差成反比。总体而言，与良好的依从性相比，依从性差与更严重的ADHD相关症状相关。在OROS和IR哌醋甲酯形式的个体内比较中证明了相似的副作用，优异的依从性和改善的疗效。结论：考虑到对药物的依从性差可能是ADHD治疗效果欠佳的重要原因，医生应在调整剂量或更换药物之前确保依从性。试验注册：clinicaltrials.gov标识符NCT00460720。

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