Medication adherence and symptom reduction in adults treated with mixed amphetamine salts in a randomized crossover study.

Abstract

OBJECTIVES:

The study objectives were to 1) evaluate medication adherence for adults with attention-deficit/hyperactivity disorder (ADHD) treated with 3 times daily (TID) mixed amphetamine salts immediate release (MAS IR) versus once-daily (qAM) MAS extended release (MAS XR) in a randomized, crossover study; and 2) to examine the associations between adherence and efficacy for MAS IR and MAS XR.

METHODS:

Sixty-two adults with ADHD were enrolled and 49 completed the study. The treatment condition order (TID-qAM or qAM-TID) was counterbalanced across participants, with an intervening washout period of ≥ 7 days. Adherence was assessed via 3 measures: 1) self-report, 2) pill count, and 3) the Medication Event Monitoring System (MEMS(®)). The primary efficacy measure was the ADHD Rating Scale (ADHD-RS); secondary measures included the Time-Sensitive ADHD Symptom Scale (TASS) and Clinical Global Impressions-Severity of Illness (CGI-S) scale.

RESULTS:

Adherence to treatment as measured by self-report and pill count was not significantly different between MAS XR and MAS IR. Adherence was significantly better for MAS XR than MAS IR for all of the MEMS(®) measures. The mean change in ADHD-RS, TASS, and CGI-S scores at endpoint was significantly improved for both MAS IR and MAS XR and did not differ significantly between groups. There was not a significant adherence by efficacy interaction.

CONCLUSION:

Adults with ADHD adhered equally well with MAS IR as with MAS XR when assessed by pill count and self-report, but not by the MEMS(®) measures. Both treatments significantly reduced ADHD symptoms, and efficacy was not significantly different between groups. Adherence was not associated with treatment outcome.

• Authors: Lenard A Adler, Lauren R Lynch, David M Shaw, Samantha P Wallace, Michael A Ciranni, Alexis M Briggie, Agatha Kulaga, Katherine E O'Donnell, Stephen V Faraone
• Journal: Postgraduate medicine (Postgrad Med) Vol. 123 Issue 5 Pg. 71-9 (Sep 2011) ISSN: 1941-9260 [Electronic] England
• PMID: 21904088 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Central Nervous System Stimulants
• Amphetamine

Topics

• Adolescent
• Adult
• Amphetamine (therapeutic use)
• Attention Deficit Disorder with Hyperactivity (drug therapy, psychology)
• Central Nervous System Stimulants (therapeutic use)
• Cross-Over Studies
• Female
• Humans
• Male
• Medication Adherence (psychology)
• Middle Aged
• Psychiatric Status Rating Scales
• Treatment Outcome
• Young Adult