Emerging challenges in pharmacotherapy research on attention-deficit hyperactivity disorder: outcome measures beyond symptom control and clinical trials

European ADHD Guidelines Group

    Research output: Contribution to journalReview article

    3 Citations (Scopus)

    Abstract

    Although pharmacological therapies are recommended as a key component in the treatment of attention-deficit hyperactivity disorder, their use continues to prompt intense debate. Despite considerable research efforts, several gaps in the knowledge base and several questions over the quality of evidence exist. Particular issues surrounding pharmacological treatments include uncertainties about long-term effectiveness and safety, safety profiles in adults, and the comparative effectiveness of different medications. In this Review, we focus on four key methodological issues for future research: (1) the use of appropriate trial designs; the need for (2) outcome measures targeting effectiveness beyond symptom control and (3) safety outcome measures; and (4) the application of clinical and administrative research databases to assess real-world outcomes. Potential solutions include increased use of randomised placebo-controlled withdrawal trials and large pharmacoepidemiological studies that use electronic health-care records on the long-term effectiveness and safety of medications. Pragmatic head-to-head randomised trials would also provide direct evidence on comparative effectiveness and safety profiles.

    Original languageEnglish
    Pages (from-to)528-537
    Number of pages10
    JournalLancet Psychiatry
    Volume6
    Issue number6
    DOIs
    Publication statusPublished - 1 Jun 2019

    Fingerprint

    Attention Deficit Disorder with Hyperactivity
    Outcome Assessment (Health Care)
    Clinical Trials
    Safety
    Drug Therapy
    Research
    Pharmacology
    Knowledge Bases
    Electronic Health Records
    Uncertainty
    Therapeutics
    Placebos
    Databases
    Delivery of Health Care

    Cite this

    @article{0e479097525e4ec7a24bcf22c187a8e5,
    title = "Emerging challenges in pharmacotherapy research on attention-deficit hyperactivity disorder: outcome measures beyond symptom control and clinical trials",
    abstract = "Although pharmacological therapies are recommended as a key component in the treatment of attention-deficit hyperactivity disorder, their use continues to prompt intense debate. Despite considerable research efforts, several gaps in the knowledge base and several questions over the quality of evidence exist. Particular issues surrounding pharmacological treatments include uncertainties about long-term effectiveness and safety, safety profiles in adults, and the comparative effectiveness of different medications. In this Review, we focus on four key methodological issues for future research: (1) the use of appropriate trial designs; the need for (2) outcome measures targeting effectiveness beyond symptom control and (3) safety outcome measures; and (4) the application of clinical and administrative research databases to assess real-world outcomes. Potential solutions include increased use of randomised placebo-controlled withdrawal trials and large pharmacoepidemiological studies that use electronic health-care records on the long-term effectiveness and safety of medications. Pragmatic head-to-head randomised trials would also provide direct evidence on comparative effectiveness and safety profiles.",
    author = "{European ADHD Guidelines Group} and Wong, {Ian C K} and Tobias Banaschewski and Jan Buitelaar and Samuele Cortese and Manfred D{\"o}pfner and Emily Simonoff and David Coghill",
    note = "Copyright {\circledC} 2019 Elsevier Ltd. All rights reserved.",
    year = "2019",
    month = "6",
    day = "1",
    doi = "10.1016/S2215-0366(19)30096-3",
    language = "English",
    volume = "6",
    pages = "528--537",
    journal = "Lancet Psychiatry",
    issn = "2215-0366",
    publisher = "Elsevier Limited",
    number = "6",

    }

    Emerging challenges in pharmacotherapy research on attention-deficit hyperactivity disorder : outcome measures beyond symptom control and clinical trials. / European ADHD Guidelines Group.

    In: Lancet Psychiatry, Vol. 6, No. 6, 01.06.2019, p. 528-537.

    Research output: Contribution to journalReview article

    TY - JOUR

    T1 - Emerging challenges in pharmacotherapy research on attention-deficit hyperactivity disorder

    T2 - outcome measures beyond symptom control and clinical trials

    AU - European ADHD Guidelines Group

    AU - Wong, Ian C K

    AU - Banaschewski, Tobias

    AU - Buitelaar, Jan

    AU - Cortese, Samuele

    AU - Döpfner, Manfred

    AU - Simonoff, Emily

    AU - Coghill, David

    N1 - Copyright © 2019 Elsevier Ltd. All rights reserved.

    PY - 2019/6/1

    Y1 - 2019/6/1

    N2 - Although pharmacological therapies are recommended as a key component in the treatment of attention-deficit hyperactivity disorder, their use continues to prompt intense debate. Despite considerable research efforts, several gaps in the knowledge base and several questions over the quality of evidence exist. Particular issues surrounding pharmacological treatments include uncertainties about long-term effectiveness and safety, safety profiles in adults, and the comparative effectiveness of different medications. In this Review, we focus on four key methodological issues for future research: (1) the use of appropriate trial designs; the need for (2) outcome measures targeting effectiveness beyond symptom control and (3) safety outcome measures; and (4) the application of clinical and administrative research databases to assess real-world outcomes. Potential solutions include increased use of randomised placebo-controlled withdrawal trials and large pharmacoepidemiological studies that use electronic health-care records on the long-term effectiveness and safety of medications. Pragmatic head-to-head randomised trials would also provide direct evidence on comparative effectiveness and safety profiles.

    AB - Although pharmacological therapies are recommended as a key component in the treatment of attention-deficit hyperactivity disorder, their use continues to prompt intense debate. Despite considerable research efforts, several gaps in the knowledge base and several questions over the quality of evidence exist. Particular issues surrounding pharmacological treatments include uncertainties about long-term effectiveness and safety, safety profiles in adults, and the comparative effectiveness of different medications. In this Review, we focus on four key methodological issues for future research: (1) the use of appropriate trial designs; the need for (2) outcome measures targeting effectiveness beyond symptom control and (3) safety outcome measures; and (4) the application of clinical and administrative research databases to assess real-world outcomes. Potential solutions include increased use of randomised placebo-controlled withdrawal trials and large pharmacoepidemiological studies that use electronic health-care records on the long-term effectiveness and safety of medications. Pragmatic head-to-head randomised trials would also provide direct evidence on comparative effectiveness and safety profiles.

    UR - http://www.scopus.com/inward/record.url?scp=85065763355&partnerID=8YFLogxK

    U2 - 10.1016/S2215-0366(19)30096-3

    DO - 10.1016/S2215-0366(19)30096-3

    M3 - Review article

    C2 - 31122482

    VL - 6

    SP - 528

    EP - 537

    JO - Lancet Psychiatry

    JF - Lancet Psychiatry

    SN - 2215-0366

    IS - 6

    ER -