Quality of Life and Outcomes Associated with Adverse Effects in Pediatric Patients with Attention-Deficit/Hyperactivity Disorder and Their Parents/Caregivers.

IF 1.5 4区 医学 Q2 PEDIATRICS
Jeff Schein, Martin Cloutier, Marjolaine Gauthier-Loiselle, Maryaline Catillon, Louise Yu, Beatrice Libchaber, Yuxi Wang, Ann Childress
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Abstract

Objectives: To assess quality of life and outcomes associated with adverse effects (AEs) in pediatric patients receiving pharmacological treatment for attention-deficit/hyperactivity disorder (ADHD) and their parents/caregivers. Methods: An online survey was conducted (10/13/2023-10/20/2023) among parents/caregivers recruited from Dynata's U.S. panel who lived with a pediatric patient (6-17 years) currently treated for ADHD. Patient and parent/caregiver characteristics and outcomes were descriptively reported. Patients were considered to have AEs if they experienced symptoms/complications in the past 30 days that appeared, worsened, or remained unchanged after initiating their latest ADHD treatment. Regression analyses were used to estimate correlations between the number of AEs and key outcomes, including patients' health-related quality of life (HRQoL; based on the Pediatric Quality of Life Inventory) and parents/caregivers' work and activity impairments (based on Work Productivity and Activity Impairment: Caregiver) and mental health (based on Patient Health Questionnaire-4). Results: A total of 401 parents/caregivers from all U.S. regions completed the survey (caregiver median age: 38 years, 58.9% female; patient median age: 11 years; 37.7% female). In the 30 days prior to data collection, 66.8% of patients had AEs (overall mean: 1.2 AEs), with insomnia/sleep disturbances and decreased appetite/weight loss being the most frequently reported (14.2% and 11.7%, respectively). The number of AEs was significantly correlated with reduced patient's HRQoL (including reduced physical, emotional, and school functioning), increased parent/caregiver's work and activity impairment, and a higher likelihood of parents/caregivers having generalized anxiety disorder or major depressive disorder, respectively (all p < 0.001). Conclusions: AEs are common among pediatric patients receiving pharmacological treatment for ADHD and are associated with poorer quality of life and outcomes in pediatric patients and their parents/caregivers. Therapies with better safety profiles may help improve patient's HRQoL and parent/caregiver outcomes.

儿童注意力缺陷/多动障碍患者及其家长/护理人员的生活质量和与不良反应相关的结果。
目的:评估接受药物治疗的注意力缺陷/多动障碍(ADHD)儿童患者及其家长/护理人员的生活质量以及与不良反应(AEs)相关的结果:评估接受药物治疗的注意力缺陷/多动障碍(ADHD)儿科患者及其父母/监护人的生活质量以及与不良反应(AEs)相关的结果。调查方法对从 Dynata 美国小组中招募的、与目前正在接受 ADHD 治疗的儿科患者(6-17 岁)共同生活的父母/照顾者进行了在线调查(10/13/2023-10/20/2023)。对患者和家长/护理人员的特征和结果进行了描述性报告。如果患者在过去 30 天内出现症状/并发症,且在开始接受最新 ADHD 治疗后症状/并发症出现、加重或保持不变,则认为患者出现了 AE。回归分析用于估算AEs数量与主要结果之间的相关性,包括患者的健康相关生活质量(HRQoL;基于儿科生活质量量表)、父母/照顾者的工作和活动障碍(基于工作生产率和活动障碍:照顾者)以及心理健康(基于患者健康问卷-4)。结果:共有来自美国各地区的 401 位父母/照顾者完成了调查(照顾者年龄中位数:38 岁,58.9% 为女性;患者年龄中位数:11 岁,37.7% 为女性)。在数据收集前的 30 天内,66.8% 的患者出现过不良反应(总平均值:1.2 次),其中失眠/睡眠障碍和食欲下降/体重减轻是最常见的症状(分别为 14.2% 和 11.7%)。AEs的数量与患者的HRQoL下降(包括身体、情绪和学习功能下降)、父母/照顾者的工作和活动障碍增加以及父母/照顾者患有广泛性焦虑症或重度抑郁症的可能性增加显著相关(所有P均<0.001)。结论AEs在接受药物治疗ADHD的儿科患者中很常见,与儿科患者及其父母/照顾者较差的生活质量和治疗效果有关。安全性更好的疗法可能有助于改善患者的 HRQoL 和家长/护理人员的治疗效果。
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来源期刊
CiteScore
3.60
自引率
5.30%
发文量
61
审稿时长
>12 weeks
期刊介绍: Journal of Child and Adolescent Psychopharmacology (JCAP) is the premier peer-reviewed journal covering the clinical aspects of treating this patient population with psychotropic medications including side effects and interactions, standard doses, and research on new and existing medications. The Journal includes information on related areas of medical sciences such as advances in developmental pharmacokinetics, developmental neuroscience, metabolism, nutrition, molecular genetics, and more. Journal of Child and Adolescent Psychopharmacology coverage includes: New drugs and treatment strategies including the use of psycho-stimulants, selective serotonin reuptake inhibitors, mood stabilizers, and atypical antipsychotics New developments in the diagnosis and treatment of ADHD, anxiety disorders, schizophrenia, autism spectrum disorders, bipolar disorder, eating disorders, along with other disorders Reports of common and rare Treatment Emergent Adverse Events (TEAEs) including: hyperprolactinemia, galactorrhea, weight gain/loss, metabolic syndrome, dyslipidemia, switching phenomena, sudden death, and the potential increase of suicide. Outcomes research.
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