Medication Continuity in Children Treated for ADHD

治疗多动症儿童的药物连续性

• 批准号: 8010154
• 负责人: William Bernard Brinkman
• 金额: $ 17.67万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-01-01 至 2014-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8010154
• 关键词: 10 year old; Address; Adherence; Adolescence; Adolescent; Age; Agreement; Area; Attention deficit hyperactivity disorder; Award; Belief; Caring; Characteristics; Child; Chronic; Chronic Disease; Clinical; Cognitive; Combined Modality Therapy; Communities; Counseling; Data; Decision Making; Development; Dose; Education; Evidence based intervention; Exercise; Family; Feedback; Fostering; Foundations; Funding; Goals; Grant; Impairment; Influentials; Injury; Intervention; Intervention Studies; Knowledge; Measurement; Medication Management; Medicine; Mentored Patient-Oriented Research Career Development Award; Methods; Modeling; Office Visits; Outcome; Parents; Patients; Pediatrics; Pharmaceutical Preparations; Pharmacological Treatment; Pharmacy facility; Physicians; Population; Populations at Risk; Primary Health Care; Public Health; Race; Records; Recruitment Activity; Regimen; Reporting; Research; Research Personnel; Role; Sampling; Self Management; Structure; Substance abuse problem; Symptoms; Therapeutic; Time; Training; Translating; Trust; Work; Writing; base; cohort; coping mechanism; design; evidence base; experience; family influence; high risk; high risk sexual behavior; improved; innovation; prevent; primary care setting; programs; prospective; psychologic; public health relevance; skills; social; sound; success; vehicular accident

DESCRIPTION (provided by applicant): This Mentored Patient-Oriented Research Career Development Award (K23) program is designed to develop expertise for becoming an independent investigator in the study of medication continuity in children with Attention-Deficit/Hyperactivity Disorder (ADHD) cared for in primary care settings. This is a critical area because despite the proven efficacy of stimulant medications to reduce ADHD symptoms, many children discontinue treatment, thereby preventing them from realizing the full therapeutic benefits of treatment and this contributes to unnecessary suffering for children and their families. The ultimate goal is to develop the expertise needed to develop evidence-based, personalized interventions to improve medication continuity among children and adolescents with ADHD. The Candidate's strong background of research and clinical training in pediatrics, education, and research provides an excellent foundation for this work. The proposed training goals include enhancing skills in the following areas: 1) biostatistical modeling with longitudinal data; 2) adherence measurement; 3) design and implementation of interventions for ADHD; 4) development of psychological, adherence, and family/self management interventions; 5) grant writing and presentation of scientific data. Achieving these training goals is essential to the Candidate's success in transitioning to independence as an investigator who pursues methodologically sound, technically feasible, and innovative approaches to intervention research in this population. The objective of the research plan is to better understand the factors that promote medication continuity in children with ADHD. A prospective, longitudinal cohort of 100 children 6-10 years old started on medicine for ADHD by their primary care doctor. The cohort will be recruited from 21 physicians in 7 practices. We will collect four waves of data over 18 months to address the following specific aims: Aim 1: Describe medication continuity in a community-based clinical cohort of children treated for ADHD. Aim 2: Identify reasons parents stop and re-start their child's medication treatment. Aim 3: Determine relationship between factors that influence family decision making and medication continuity. The Candidate plans to achieve his goal by translating knowledge gained from this study to 1) segment the population at risk for poor medication continuity and, 2) develop personalized interventions that target modifiable factors important to promote medication continuity. PUBLIC HEALTH RELEVANCE: The proposed work is significant because ADHD results in impairment of academic, social, and family functioning. In addition, children with ADHD are at higher risk for injury, and as they reach adolescence are at higher risk for motor vehicle accidents, substance abuse, and risky sexual behavior. Poor medication continuity, therefore, contributes to unnecessary child, adolescent, and family suffering.

描述（由申请人提供）：这项以患者为导向的研究职业发展奖（K23）计划旨在培养专业知识，成为一名独立研究者，研究初级保健机构护理的注意力缺陷/多动症（ADHD）儿童的药物连续性。这是一个关键领域，因为尽管兴奋剂药物已被证明可以有效减轻多动症症状，但许多儿童停止治疗，从而使他们无法实现治疗的全部治疗效果，这给儿童及其家庭带来了不必要的痛苦。最终目标是发展所需的专业知识，以开发基于证据的个性化干预措施，以改善患有多动症的儿童和青少年的药物连续性。候选人在儿科、教育和研究方面深厚的研究和临床培训背景为这项工作奠定了良好的基础。拟议的培训目标包括增强以下领域的技能：1）利用纵向数据进行生物统计建模； 2）依从性测量； 3）设计和实施多动症干预措施； 4) 制定心理、依从性和家庭/自我管理干预措施； 5) 科学数据的撰写和呈现。实现这些培训目标对于候选人成功过渡为独立的研究者至关重要，他追求方法论上合理、技术上可行和创新的方法来对该人群进行干预研究。该研究计划的目的是更好地了解促进多动症儿童用药连续性的因素。一项由 100 名 6-10 岁儿童组成的前瞻性纵向队列研究开始由他们的初级保健医生接受治疗多动症的药物。该队列将从 7 个诊所的 21 名医生中招募。我们将在 18 个月内收集四波数据，以实现以下具体目标： 目标 1：描述基于社区的 ADHD 儿童临床队列的药物连续性。目标 2：找出父母停止并重新开始孩子药物治疗的原因。目标 3：确定影响家庭决策的因素与药物连续性之间的关系。候选人计划通过将从本研究中获得的知识转化为 1) 对面临药物连续性不良风险的人群进行细分，2) 制定个性化干预措施，针对对促进药物连续性重要的可修改因素。 公共卫生相关性：拟议的工作意义重大，因为多动症会导致学业、社交和家庭功能受损。此外，患有多动症的儿童受伤的风险更高，并且当他们进入青春期时，发生机动车事故、药物滥用和危险性行为的风险也更高。因此，药物连续性差会导致儿童、青少年和家庭不必要的痛苦。