Journal of the Korean Academy of Child and Adolescent Psychiatry

Korean Academy of Child and Adolescent Psychiatry (대한소아청소년정신의학회)
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Treatment Adherence of Osmotic-Controlled Release Oral Delivery System Methylphenidate in Korean Children and Adolescents with Attention-Deficit Hyperactivity Disorder

주의력결핍 과잉행동장애 아동에서 Osmotic-Controlled Release Oral Delivery System Methylphenidate의 치료순응도

  • Kim, Bongseog (Department of Psychiatry, Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Lee, Jeong-Seop (Department of Psychiatry, Inha University College of Medicine) ;
  • Kim, Eui-Jung (Department of Psychiatry, Ewha Womans University School of Medicine) ;
  • Sung, Hyung-Mo (Department of Psychiatry, CHA Gumi Medical Center, College of Medicine, CHA University) ;
  • Shin, Yun Mi (Department of Psychiatry, Ajou University School of Medicine) ;
  • Hwang, Seong-Hye (Haesue Child Psychiatric Clinic) ;
  • Yoo, Hanik K. (Seoul Brain Research Institute)
  • 김봉석 (인제대학교 의과대학 상계백병원 정신건강의학교실) ;
  • 이정섭 (인하대학교 의과대학 정신건강의학교실) ;
  • 김의정 (이화여자대학교 의학전문대학원 정신건강의학교실) ;
  • 성형모 (CHA의과학대학교 구미차병원 정신건강의학교실) ;
  • 신윤미 (아주대학교 의과대학 정신건강의학교실) ;
  • 황성혜 (해수소중한아이정신과의원) ;
  • 유한익 (서울뇌과학연구소)
  • Received : 2013.07.25
  • Accepted : 2014.04.18
  • Published : 2014.06.30
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Abstract

Objectives : The objective of this study was to evaluate the treatment duration and adherence of osmotic-controlled release oral delivery system (OROS) methylphenidate for treatment of attention-deficit hyperactivity disorder (ADHD). Methods : A total of 843 children with ADHD were recruited : 213 children (25.3%) who had previously taken medications for ADHD and 630 drug-na$\ddot{i}$ve children (74.7%) were recruited. The dosage was adjusted according to the clinician's judgment. The primary efficacy endpoint of this study was treatment retention rate, which was estimated at Week 12 and Week 20 using the Kaplan-Meier curve. The Swanson, Nolan and Pelham-IV (SNAP-IV), Clinical Global Impression-Severity (CGI-S), Clinical Global Impression-Improvement, and the side effect rating scale were measured at every visit. Remission rates were presented based on SNAP-IV and CGI-S, respectively. Results : The treatment retention rate at 12 weeks and at 20 weeks was 76.2% and 66.8%, respectively. Divided according to 6-8, 9-11, 12-14 and 15-18 years of age, younger children tended to show a statistically higher treatment retention rate (p=.02). Based on SNAP-IV and CGI scores, children with better response to medication showed tendencies of statistically higher treatment retention rate. The most common adverse events included loss of appetite (7.1%) and insomnia (3.3%). There was no serious adverse event related to the treatment, such as death. Conclusion : The use of OROS methylphenidate for treatment of ADHD was safe and tolerable for children. In this study, lower age and better treatment response showed a statistically significant relationship with higher treatment adherence. Boys showed a trend of high treatment adherence. The treatment adherence at 20 weeks was satisfactory, however, the treatment adherence after 20 weeks showed a sharp decrease. Therefore, treatment persistence for six months after the beginning of ADHD treatment is important. In addition, the positive role of psycho-education for children and parents is necessary for increasing treatment adherence.

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