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Attention-deficit/hyperactivity disorder Under Treatment Outcomes Research (AUTOR): a European observational study in pediatric subjects.

Haynes V, Lopez-Romero P, Anand E - Atten Defic Hyperact Disord (2015)

Bottom Line: Among the secondary objectives, initial use of atomoxetine (vs. stimulants) was associated with a significant improvement on the CHIP-CE PRF total score, with an adjusted treatment difference of -6.0 (95 % CI -7.9, -4.1) at 24 months.Additionally, the odds of stability (CGI-ADHD-S ≤ 3 over the 2-year period) were significantly lower for subjects initially responding to stimulants compared with atomoxetine (OR 0.5; 95 % CI 0.3, 0.8).Response to initial treatment with atomoxetine was associated with improved QoL over 2 years.

View Article: PubMed Central - PubMed

Affiliation: Lilly Corporate Center, Eli Lilly and Company, Indianapolis, IN, 46285, USA. ginger.haynes@lilly.com.

ABSTRACT
The ADHD Under Treatment Observational Research (AUTOR) study was a European prospective, observational study that assessed factors associated with changes in ADHD severity, estimated change from baseline in quality of life (QoL), and characterized changes in ADHD symptoms over a 2-year period as a function of baseline treatment. The primary objective was to identify factors associated with worsening in ADHD severity during a 2-year follow-up period for subjects aged 6-17 years, who were receiving the same pharmacotherapy for 3-8 months before enrollment and had a Clinical Global Impression (CGI)-ADHD-Severity score of mild/lower and a CGI-ADHD-Improvement score of improved/very much improved. Multivariate logistic regression examined the association of factors with worsening in ADHD. Mixed-model repeated measures regression analyzed QoL in terms of change from baseline in CHIP-CE PRF scores. There were 704 subjects analyzed. Variables associated with worsening ADHD severity were parental occupation, poorer school outcomes, and use of psychoeducation; baseline treatment was not significant. Among the secondary objectives, initial use of atomoxetine (vs. stimulants) was associated with a significant improvement on the CHIP-CE PRF total score, with an adjusted treatment difference of -6.0 (95 % CI -7.9, -4.1) at 24 months. Additionally, the odds of stability (CGI-ADHD-S ≤ 3 over the 2-year period) were significantly lower for subjects initially responding to stimulants compared with atomoxetine (OR 0.5; 95 % CI 0.3, 0.8). ADHD symptom worsening was associated with initial use of psychoeducation, parental occupation, and poorer school outcomes. Response to initial treatment with atomoxetine was associated with improved QoL over 2 years.

No MeSH data available.


Related in: MedlinePlus

Factors associated with an increase in symptom severity in subjects with attention-deficit/hyperactivity disorder (from a multivariate logistic regression model). For each factor, adjusted odds ratios comparing each level against the baseline reference level and associated 95 % CI and Type III p values are presented. Additionally, for factors with more than 2 levels, corresponding homogeneity Type III p values are also shown. Estimates from the logistic regression model that included propensity scores and/or treatment compliance as time-varying covariates as additional adjusting factors were similar to the models without these additional adjustments. Abbreviations: 0 school outcome of manageable in a classroom environment; 1 school outcome of some exclusion from school lessons and/or in a special education program, 2 school outcome of not in school during the past 3 months, suspended from school, expelled from school, and/or requested to change to a special need school, CI confidence interval, LL lower limit, UL upper limit, vs. versus
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Fig5: Factors associated with an increase in symptom severity in subjects with attention-deficit/hyperactivity disorder (from a multivariate logistic regression model). For each factor, adjusted odds ratios comparing each level against the baseline reference level and associated 95 % CI and Type III p values are presented. Additionally, for factors with more than 2 levels, corresponding homogeneity Type III p values are also shown. Estimates from the logistic regression model that included propensity scores and/or treatment compliance as time-varying covariates as additional adjusting factors were similar to the models without these additional adjustments. Abbreviations: 0 school outcome of manageable in a classroom environment; 1 school outcome of some exclusion from school lessons and/or in a special education program, 2 school outcome of not in school during the past 3 months, suspended from school, expelled from school, and/or requested to change to a special need school, CI confidence interval, LL lower limit, UL upper limit, vs. versus

Mentions: Figure 5 presents the results from the multivariate logistic model estimated without PS and/or time-varying covariates. School outcome was statistically significant (Type III p < 0.001), with the odds of an increase in ADHD symptoms severity being significantly greater for subjects who had some exclusion from school lessons and/or were in a special education program than for subjects who were manageable in a classroom environment (odds ratio [95 % CI]; 2.7 [1.5–4.8]; p < 0.001). The odds of an increase in ADHD symptom severity were significantly greater in subjects who were not in school during the past 3 months, who were suspended from school, who were expelled from school, and/or who were requested to change to a special need school than in subjects who were manageable in a classroom environment at baseline (odds ratio [95 % CI]; 5.0 [1.4–18.2]; p = 0.015). Baseline parental occupation was also statistically significant (Type III p = 0.003) overall; however, none of the specific pairwise comparisons between parental occupations to the arbitrary reference group (managers and senior officials) were statistically significant. The odds of an increase in ADHD symptom severity were also significantly greater for subjects who received psychoeducation at baseline than for subjects who did not receive it at baseline (odds ratio [95 % CI]; 2.2 [1.3–3.7]; p = 0.004).Fig. 5


Attention-deficit/hyperactivity disorder Under Treatment Outcomes Research (AUTOR): a European observational study in pediatric subjects.

Haynes V, Lopez-Romero P, Anand E - Atten Defic Hyperact Disord (2015)

Factors associated with an increase in symptom severity in subjects with attention-deficit/hyperactivity disorder (from a multivariate logistic regression model). For each factor, adjusted odds ratios comparing each level against the baseline reference level and associated 95 % CI and Type III p values are presented. Additionally, for factors with more than 2 levels, corresponding homogeneity Type III p values are also shown. Estimates from the logistic regression model that included propensity scores and/or treatment compliance as time-varying covariates as additional adjusting factors were similar to the models without these additional adjustments. Abbreviations: 0 school outcome of manageable in a classroom environment; 1 school outcome of some exclusion from school lessons and/or in a special education program, 2 school outcome of not in school during the past 3 months, suspended from school, expelled from school, and/or requested to change to a special need school, CI confidence interval, LL lower limit, UL upper limit, vs. versus
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4644194&req=5

Fig5: Factors associated with an increase in symptom severity in subjects with attention-deficit/hyperactivity disorder (from a multivariate logistic regression model). For each factor, adjusted odds ratios comparing each level against the baseline reference level and associated 95 % CI and Type III p values are presented. Additionally, for factors with more than 2 levels, corresponding homogeneity Type III p values are also shown. Estimates from the logistic regression model that included propensity scores and/or treatment compliance as time-varying covariates as additional adjusting factors were similar to the models without these additional adjustments. Abbreviations: 0 school outcome of manageable in a classroom environment; 1 school outcome of some exclusion from school lessons and/or in a special education program, 2 school outcome of not in school during the past 3 months, suspended from school, expelled from school, and/or requested to change to a special need school, CI confidence interval, LL lower limit, UL upper limit, vs. versus
Mentions: Figure 5 presents the results from the multivariate logistic model estimated without PS and/or time-varying covariates. School outcome was statistically significant (Type III p < 0.001), with the odds of an increase in ADHD symptoms severity being significantly greater for subjects who had some exclusion from school lessons and/or were in a special education program than for subjects who were manageable in a classroom environment (odds ratio [95 % CI]; 2.7 [1.5–4.8]; p < 0.001). The odds of an increase in ADHD symptom severity were significantly greater in subjects who were not in school during the past 3 months, who were suspended from school, who were expelled from school, and/or who were requested to change to a special need school than in subjects who were manageable in a classroom environment at baseline (odds ratio [95 % CI]; 5.0 [1.4–18.2]; p = 0.015). Baseline parental occupation was also statistically significant (Type III p = 0.003) overall; however, none of the specific pairwise comparisons between parental occupations to the arbitrary reference group (managers and senior officials) were statistically significant. The odds of an increase in ADHD symptom severity were also significantly greater for subjects who received psychoeducation at baseline than for subjects who did not receive it at baseline (odds ratio [95 % CI]; 2.2 [1.3–3.7]; p = 0.004).Fig. 5

Bottom Line: Among the secondary objectives, initial use of atomoxetine (vs. stimulants) was associated with a significant improvement on the CHIP-CE PRF total score, with an adjusted treatment difference of -6.0 (95 % CI -7.9, -4.1) at 24 months.Additionally, the odds of stability (CGI-ADHD-S ≤ 3 over the 2-year period) were significantly lower for subjects initially responding to stimulants compared with atomoxetine (OR 0.5; 95 % CI 0.3, 0.8).Response to initial treatment with atomoxetine was associated with improved QoL over 2 years.

View Article: PubMed Central - PubMed

Affiliation: Lilly Corporate Center, Eli Lilly and Company, Indianapolis, IN, 46285, USA. ginger.haynes@lilly.com.

ABSTRACT
The ADHD Under Treatment Observational Research (AUTOR) study was a European prospective, observational study that assessed factors associated with changes in ADHD severity, estimated change from baseline in quality of life (QoL), and characterized changes in ADHD symptoms over a 2-year period as a function of baseline treatment. The primary objective was to identify factors associated with worsening in ADHD severity during a 2-year follow-up period for subjects aged 6-17 years, who were receiving the same pharmacotherapy for 3-8 months before enrollment and had a Clinical Global Impression (CGI)-ADHD-Severity score of mild/lower and a CGI-ADHD-Improvement score of improved/very much improved. Multivariate logistic regression examined the association of factors with worsening in ADHD. Mixed-model repeated measures regression analyzed QoL in terms of change from baseline in CHIP-CE PRF scores. There were 704 subjects analyzed. Variables associated with worsening ADHD severity were parental occupation, poorer school outcomes, and use of psychoeducation; baseline treatment was not significant. Among the secondary objectives, initial use of atomoxetine (vs. stimulants) was associated with a significant improvement on the CHIP-CE PRF total score, with an adjusted treatment difference of -6.0 (95 % CI -7.9, -4.1) at 24 months. Additionally, the odds of stability (CGI-ADHD-S ≤ 3 over the 2-year period) were significantly lower for subjects initially responding to stimulants compared with atomoxetine (OR 0.5; 95 % CI 0.3, 0.8). ADHD symptom worsening was associated with initial use of psychoeducation, parental occupation, and poorer school outcomes. Response to initial treatment with atomoxetine was associated with improved QoL over 2 years.

No MeSH data available.


Related in: MedlinePlus