Evaluation of patients' and parents' quality of life in a randomized placebo-controlled atomoxetine study in attention-deficit/hyperactivity disorder.
ABSTRACT The aim of this study was to demonstrate the superior efficacy of atomoxetine with respect to placebo and to compare parent and child perceptions of health-related quality of life (HRQoL).
This randomized, placebo-controlled, 12-week parallel clinical trial included 151 untreated children/adolescents with newly diagnosed attention-deficit/hyperactivity disorder (ADHD). Parents' and patients' reports of HRQoL were obtained separately using the Child Health and Illness Profile and compared using analysis of covariance.
The ADHD Rating Scale baseline mean score was 39.21. Baseline HRQoL was perceived as considerably compromised by parents, especially in the risk avoidance and achievement domains (mean t-scores, 32.47 and 33.16, respectively), but less by children, and restricted to the achievement domain (mean t-score, 41.54). Atomoxetine improved HRQoL with respect to placebo in these two domains as assessed by parents (difference between adjusted mean changes and 95% confidence interval, 8.53, 4.05-13.00 and 3.39, 0.13-6.65) and in the risk avoidance domain by patients (3.56, 1.04-6.07). A modest correlation of clinical severity with HRQoL was found in this clinical population.
This study confirms prior reports the impact of ADHD on the HRQoL of patients as assessed by their parents. The patients' perspective is of a lesser impact. Atomoxetine improved HRQoL as assessed by both parents and patients.
Article: A randomized controlled trial investigation of a non-stimulant in attention deficit hyperactivity disorder (ACTION): rationale and design.[show abstract] [hide abstract]
ABSTRACT: The ACTION study (Attention deficit hyperactivity disorder Controlled Trial Investigation Of a Non-stimulant) is a multi-center, double-blind, randomized cross-over trial of the non-stimulant medication, Atomoxetine, in children and adolescents with attention deficit hyperactivity disorder (ADHD). The primary aims are to examine the efficacy of atomoxetine for improving cognition and emotional function in ADHD and whether any improvements in these outcomes are more pronounced in participants with comorbid anxiety; and to determine if changes in these outcomes after atomoxetine are more reliable than changes in diagnostic symptoms of ADHD. This manuscript will describe the methodology and rationale for the ACTION study. Children and adolescents aged 6 - 17 y with ADHD will be enrolled. Clinical interview and validated scales will be used to confirm diagnosis and screen for exclusion criteria, which include concurrent stimulant use, and comorbid psychiatric or neurological conditions other than anxiety. Three assessment sessions will be conducted over the 13-week study period: Session 1 (Baseline, pre-treatment), Session 2 (six weeks, atomoxetine or placebo), and Session 3 (13 weeks, cross-over after one-week washout period). The standardized touch-screen battery, "IntegNeuro™", will be used to assess cognitive and emotional function. The primary measure of response will be symptom ratings, while quality of life will be a secondary outcome. Logistic regression will be used to determine predictors of treatment response, while repeated measures of analysis will determine any differences in effect of atomoxetine and placebo. The methodology for the ACTION study has been detailed. The ACTION study is the first controlled trial to investigate the efficacy of atomoxetine using objective cognitive and emotional function markers, and whether these objective measures predict outcomes with atomoxetine in ADHD with and without comorbid anxiety. First enrollment was in March 2008. The outcomes of this study will be a significant step towards a 'personalized medicine' (and therefore a more efficient) approach to ADHD treatment. Australian and New Zealand Clinical Trials Registry ANZCTRN12607000535471.Trials 03/2011; 12:77. · 2.02 Impact Factor