Medication Continuity in Children Treated for ADHD

治疗多动症儿童的药物连续性

• 批准号: 8197016
• 负责人: William Bernard Brinkman
• 金额: $ 17.65万
• 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/8197016
• 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）：这个指导的以患者为导向的研究职业发展奖（K23）计划旨在发展专业知识，成为一个独立的研究者在药物治疗的连续性在儿童注意力缺陷/多动障碍（ADHD）在初级保健机构照顾。这是一个关键领域，因为尽管兴奋剂药物已被证明有效减少ADHD症状，但许多儿童停止治疗，从而阻止他们实现治疗的全部治疗益处，这导致儿童及其家庭遭受不必要的痛苦。最终目标是发展所需的专业知识，以制定基于证据的个性化干预措施，以改善ADHD儿童和青少年的用药连续性。候选人在儿科，教育和研究方面的强大研究和临床培训背景为这项工作提供了良好的基础。拟议的培训目标包括提高以下领域的技能：1）纵向数据的生物统计建模; 2）依从性测量; 3）ADHD干预措施的设计和实施; 4）心理，依从性和家庭/自我管理干预措施的开发; 5）科学数据的赠款写作和演示。实现这些培训目标是至关重要的候选人的成功过渡到独立的研究者谁追求方法健全，技术上可行的，创新的方法，在这一人群的干预研究。该研究计划的目的是更好地了解促进ADHD儿童用药连续性的因素。一项前瞻性的纵向队列研究，包括100名6-10岁的儿童，他们的初级保健医生开始服用ADHD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，以解决以下具体目标：目标1：描述ADHD治疗儿童的社区临床队列中的药物连续性。目的2：确定父母停止和重新开始孩子药物治疗的原因。目的3：确定影响家庭决策和药物连续性的因素之间的关系。候选人计划通过将从本研究中获得的知识转化为1）细分药物连续性差的风险人群，2）制定针对对促进药物连续性重要的可修改因素的个性化干预措施来实现其目标。 公共卫生相关性：拟议的工作是重要的，因为ADHD会导致学术，社会和家庭功能的损害。此外，患有ADHD的儿童受伤的风险更高，当他们进入青春期时，机动车事故，药物滥用和危险性行为的风险更高。因此，不良的用药连续性会给儿童、青少年和家庭带来不必要的痛苦。