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Medication adherence and symptom reduction in adults treated with mixed amphetamine salts in a randomized crossover study.
Postgrad Med. 2011 Sep; 123(5):71-9.PM

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+Show Affiliations

Department of Psychiatry, NYU School of Medicine, New York, NY 10016, USA. lenard.adler@nyumc.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21904088

Citation

Adler, Lenard A., et al. "Medication Adherence and Symptom Reduction in Adults Treated With Mixed Amphetamine Salts in a Randomized Crossover Study." Postgraduate Medicine, vol. 123, no. 5, 2011, pp. 71-9.
Adler LA, Lynch LR, Shaw DM, et al. Medication adherence and symptom reduction in adults treated with mixed amphetamine salts in a randomized crossover study. Postgrad Med. 2011;123(5):71-9.
Adler, L. A., Lynch, L. R., Shaw, D. M., Wallace, S. P., Ciranni, M. A., Briggie, A. M., Kulaga, A., O'Donnell, K. E., & Faraone, S. V. (2011). Medication adherence and symptom reduction in adults treated with mixed amphetamine salts in a randomized crossover study. Postgraduate Medicine, 123(5), 71-9. https://doi.org/10.3810/pgm.2011.09.2461
Adler LA, et al. Medication Adherence and Symptom Reduction in Adults Treated With Mixed Amphetamine Salts in a Randomized Crossover Study. Postgrad Med. 2011;123(5):71-9. PubMed PMID: 21904088.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Medication adherence and symptom reduction in adults treated with mixed amphetamine salts in a randomized crossover study. AU - Adler,Lenard A, AU - Lynch,Lauren R, AU - Shaw,David M, AU - Wallace,Samantha P, AU - Ciranni,Michael A, AU - Briggie,Alexis M, AU - Kulaga,Agatha, AU - O'Donnell,Katherine E, AU - Faraone,Stephen V, PY - 2011/9/10/entrez PY - 2011/9/10/pubmed PY - 2011/11/9/medline SP - 71 EP - 9 JF - Postgraduate medicine JO - Postgrad Med VL - 123 IS - 5 N2 - 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. SN - 1941-9260 UR - https://www.unboundmedicine.com/medline/citation/21904088/Medication_adherence_and_symptom_reduction_in_adults_treated_with_mixed_amphetamine_salts_in_a_randomized_crossover_study_ L2 - http://www.tandfonline.com/doi/full/10.3810/pgm.2011.09.2461 DB - PRIME DP - Unbound Medicine ER -