Adhering to medication for attention-deficit/hyperactivity disorder in children

Despite the availability of well-established psychosocial and pharmacological treatments for attention-deficit/hyperactivity disorder (ADHD), it remains a disorder with substantial impact on public health and individual families. Though the rate of adherence to ADHD medication is similar to that of other pediatric chronic conditions, research with this population is more limited. The current study explored the hypothesis that recognition by caregivers of child functional impairment, and caregiver perception of the doctor's medication recommendation as "hasty" would account for statistically significant variance in adherence to ADHD medication. Fourteen caregivers of children between the ages of 6 and 12 years diagnosed with ADHD and prescribed an index medication within 6 months of recruitment participated in the current study. Measures included medication recommendation visual analog scale, Southampton ADHD Medication Behaviour and Attitudes Scale, Stimulant Adherence Measure, Vanderbilt ADHD Diagnostic Parent Rating Scale, and pharmacy data (i.e., medication possession ratios [MPR]). We found significant correlations between adherence (i.e., MPR) and the following: number of days included in the MPR, τ = - .41, p (one-tailed) = .05, percent of children at Title 1 school considered low-income, τ = - .50, p (two-tailed) = .07, and highest grade-level completed by participant being greater than high school, τ = - .41, p (two-tailed) = .10. While the hypothesis was not supported, the relationships were in the hypothesized direction and warrant further investigation with a larger sample size. Clinicians who wish to improve adherence to ADHD medication in children may do so by working toward improving interactions between physician and caregivers (e.g., increasing shared decision-making between physician and caregivers)

Headstrong intervention for pediatric migraine headache: a randomized clinical trial

Background The purpose of this study was to evaluate the efficacy of a self-guided CD-ROM program (“Headstrong”) containing cognitive-behavioral self-management strategies versus an educational CD-ROM program for treating headaches, headache-related disability, and quality of life. Methods Participants were 35 children ages 7–12 years with migraine recruited from one university medical center and two children’s hospital headache clinics. Participants were randomly assigned to complete the Headstrong or educational control CD-ROM program over a 4-week period. Data on headache frequency, duration, and severity, migraine-related disability, and quality of life (QOL) were obtained at baseline, post-intervention, and 3-months post-intervention. Results At post-intervention, Headstrong resulted in lower severity (on a 10-point scale) than the control group by child report (5.06 ± 1.50 SD vs. 6.25 ± 1.92 SD, p = 0.03, ES = 0.7). At 3-months post-intervention, parents reported less migraine-related disability (on the PedMIDAS) in the Headstrong group compared to the control group (1.36 ± 2.06 SD vs. 5.18 ± 6.40 SD; p = 0.04, ES = 0.8). There were no other group differences at post treatment or at 3-months post-intervention. Conclusions When compared to an educational control, Headstrong resulted in lower pain severity at post-treatment and less migraine-related disability at 3-months post-intervention, by child and parent report respectively. Headache frequency and quality of life did not change more for Headstrong versus control. Additional research is needed on the Headstrong Program to increase its efficacy and to test it with a larger sample recruited from multiple centers simultaneously.The study reported in this paper was funded by a grant from the National Institutes of Health, (National Institute of Neurological Disorders and Stroke), R01-NS046641, Michael Rapoff, Principal Investigator

Carta de 1960-08-19 a José Ferrater Mora des de Wayne (Estats Units d'Amèrica)

Litzenburg espera una resposta afirmativa a la seva invitació per dictar una conferència en el Student Chistian Movemen