Medication for childhood ADHD: Adults' outcomes and accounts after long-term treatment.

儿童多动症药物治疗：成人长期治疗后的结果和情况。

• 批准号: 2399909
• 金额: --
• 依托单位: UNIVERSITY OF EXETER
• 依托单位国家: 英国
• 项目类别: Studentship
• 财政年份: 2020
• 资助国家: 英国
• 起止时间: 2020 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=studentship-2399909
• 关键词: Medication; childhood; ADHD; Adults; outcomes

This PhD project will assess outcomes for adults (aged 18+ years) who took medication to treat their ADHD for 3 years or more when they were children. MOCA will be a mixed methods project using qualitative research (Strand 1) to examine first person accounts that in turn inform epidemiological research (Strand 2). The research will involve PPI with parents of children with ADHD and adults with ADHD. These individuals may also be participants in the strand 1 studies.An estimated 750,000 children and adolescents (aged 3-17) in Europe are currently taking medication for Attention Deficit Hyperactivity Disorder (ADHD), with most prescribed methylphenidate. Clinical guidelines recommend drug treatment for severe cases of childhood ADHD, but evidence for benefits is largely drawn from randomised controlled trials in the US, most assessing medication use over short periods of time and with short term follow up. Work on adult outcomes has concentrated on reduction in ADHD symptoms and assessing public health concerns (e.g. criminality, substance abuse). To the best of our knowledge nobody has asked adults with ADHD themselves and parents of children with ADHD what outcomes are important to them, and tested whether these are improved by ADHD medication. Importantly, adult outcome data for those who received ADHD medication as children has only recently become available in the UK, as ADHD medication has only been given to children in large numbers relatively recently, so a cohort of young adults who have taken ADHD medication long-term is novel. Research questions:Strand 11) How do adults with ADHD regard medication, and what aspects of their lives have been affected as a result? 2) What adult outcomes after medication for ADHD are of most interest to adults and parents? Strand 23) Does long-term medication for ADHD (>3 years) in childhood continue to have an impact on outcomes of interest (established in strand 1) at adulthood (5-10 years after medication initiation)?MethodsStrand 1. Qualitative data will be collected via focus groups and semi-structured interviews with adults with ADHD, half of whom have taken medication for more than 3 years, and half who have never taken medication. An on-line survey will be conducted to establish which long-term outcomes are most important to people with ADHD. Strand 2. Analysis of a UK population-representative cohort (the UK Millennium Cohort Study) will examine trends in ADHD medication data, and assess the association of long term ADHD medication with adult outcomes identified in strand 1. Comparisons of the trajectories of individuals with diagnosed ADHD and >3 years medication, ADHD with no medication and no ADHD will be conducted utilising longitudinal repeated measures mixed effects modelling. The analyses will be controlling for ADHD severity using Strengths and Difficulties SDQ Hyperactivity scores. Where repeated measures on outcomes are not available, analyses will explore differences in outcomes between those with medicated ADHD, un-medicated ADHD and no ADHD.

这个博士项目将评估成年人（18岁以上）的结果，他们在儿童时期服用药物治疗ADHD 3年或更长时间。莫卡将是一个混合方法项目，使用定性研究（Strand 1）来检查第一人称账户，从而为流行病学研究提供信息（Strand 2）。这项研究将涉及PPI与ADHD儿童和ADHD成人的父母。这些人也可能是strand 1研究的参与者。据估计，欧洲目前有75万儿童和青少年（3-17岁）正在服用治疗注意力缺陷多动障碍（ADHD）的药物，其中大多数是哌甲酯。临床指南建议对严重的儿童ADHD病例进行药物治疗，但获益的证据主要来自美国的随机对照试验，大多数评估药物在短时间内的使用和短期随访。关于成人结果的工作集中在减少ADHD症状和评估公共卫生问题（例如犯罪，药物滥用）。据我们所知，没有人问过ADHD成年人自己和ADHD儿童的父母，什么结果对他们很重要，并测试过ADHD药物是否能改善这些结果。重要的是，儿童时期接受ADHD药物治疗的成年人的结果数据最近才在英国公布，因为ADHD药物只是最近才大量给予儿童，因此长期服用ADHD药物的年轻人队列是新颖的。研究问题：Strand 11）患有ADHD的成年人如何看待药物，以及他们生活的哪些方面因此受到影响？2)成人和家长最感兴趣的ADHD药物治疗后的成人结果是什么？儿童期ADHD的长期药物治疗（>3年）是否会继续影响成年期（药物治疗开始后5-10年）的关注结果（在第1链中建立）？方法链1.定性数据将通过焦点小组和与ADHD成年人的半结构化访谈收集，其中一半人服用药物超过3年，另一半人从未服用药物。将进行在线调查，以确定哪些长期结果对ADHD患者最重要。2号线对英国人群代表性队列（英国千禧队列研究）的分析将检查ADHD药物数据的趋势，并评估长期ADHD药物与第1链中确定的成人结局的相关性。将使用纵向重复测量混合效应模型对诊断为ADHD和>3年药物治疗、ADHD无药物治疗和无ADHD的个体的轨迹进行比较。分析将使用优势和困难SDQ多动评分控制ADHD严重程度。如果无法获得重复的结局指标，则分析将探索药物治疗ADHD、未治疗ADHD和未治疗ADHD患者之间的结局差异。