Management Strategies for Attention-Deficit/Hyperactivity Disorder:

A Regional Deliberation on the Evidence

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Sarah K. Emond, MPP; Daniel A. Ollendorf, MPH, ARM; Jennifer A. Colby, PharmD; Sarah Jane Reed, MSc; Steven D. Pearson, MD, MSc, FRCP

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Postgraduate Medicine:

Volume 124 No. 5

Category:

Clinical Focus

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DOI: 10.3810/pgm.2012.09.2594
Abstract: Parents, clinicians, and policymakers require the latest evidence to help inform treatment decisions. The New England Comparative Effectiveness Public Advisory Council (CEPAC) leverages existing federally produced comparative effectiveness research supplemented with additional clinical and economic analyses to deliberate on the latest evidence. At its June 2012 meeting, the CEPAC voted on the evidence for the treatment of attention-deficit/hyperactivity disorder (ADHD) in preschoolers and school-aged children. The CEPAC voted unanimously that parent behavior training was better than usual care (eg, wait-list control) for the preschool population. They also judged it to be of “reasonable value” compared with usual care. The CEPAC also stipulated unanimously that medications are better than usual care (eg, services provided at individual practitioner discretion) for school-aged children in regards to long-term effectiveness and safety. The CEPAC members and clinical experts recommended the increased use of parent behavior training as first-line therapy for preschoolers and emphasized the importance of proper monitoring of and dosing for all children who receive medication for their ADHD symptoms. The ADHD CEPAC meeting demonstrated the important role that a public, transparent deliberation on the latest medical evidence can have in supporting informed decision making and efficient use of health care resources.

Keywords: attention-deficit/hyperactivity disorder; evidence review; deliberation; New England; comparative effectiveness