scholarly journals Objective Evaluation of Therapeutic Effects of ADHD Medication Using a Smart Watch: A Pilot Study

2020 ◽  
Vol 10 (17) ◽  
pp. 5946
Author(s):  
Chen-Sen Ouyang ◽  
Rei-Cheng Yang ◽  
Ching-Tai Chiang ◽  
Rong-Ching Wu ◽  
Lung-Chang Lin

Attention-deficit hyperactivity disorder (ADHD) is the most common neurobehavioral disorder in schoolchildren. Several methods are used to evaluate ADHD therapeutic effects, including the Swanson, Nolan, and Pelham (SNAP) questionnaire, the Vanderbilt ADHD Diagnostic Rating Scale, and the visual analog scale. However, these scales are subjective. In this study, we employed an objective method to evaluate the aforementioned therapeutic effects. Ten patients (nine boys and one girl) with ADHD were enrolled. An accelerometer was embedded in a smart watch to record the movements of patients with ADHD. The variance values of the accelerometer before and after one month of medication (methylphenidate) use were compared. The results demonstrated that the variance values along the y- and z-axes of the accelerometers significantly decreased after one month of methylphenidate use. Before and after one month of methylphenidate use, the variance values were 4.4227 ± 2.1723 and 2.3214 ± 0.6475 (p = 0.0119) on the y-axis, and 4.0933 ± 1.5720 and 2.4091 ± 0.8141 (p = 0.0140) on the z-axis, respectively. In addition, the correlation was moderate-to-strong between the SNAP hyperactivity subscale and variance along the y-axis. Thus, a smart watch with an accelerometer inside is potentially an objective and useful method for evaluating the therapeutic effects of ADHD medications.

Author(s):  
Chen-Sen Ouyang ◽  
Yi-Hung Chiu ◽  
Ching-Tai Chiang ◽  
Rong-Ching Wu ◽  
Ying-Tong Lin ◽  
...  

Attention-deficit/hyperactivity disorder (ADHD) is the most common neuropsychiatric disorder in children. Several scales are available to evaluate ADHD therapeutic effects, including the Swanson, Nolan, and Pelham (SNAP) questionnaire, the Vanderbilt ADHD Diagnostic Rating Scale, and the visual analog scale. However, these scales are subjective. In the present study, we proposed an objective and automatic approach for evaluating the therapeutic effects of medication in patients with (ADHD). The approach involved using movement quantification of patients’ skeletons detected automatically with OpenPose in outpatient videos. Eleven skeleton parameter series were calculated from the detected skeleton sequence, and the corresponding 33 features were extracted using autocorrelation and variance analysis. This study enrolled 25 patients with ADHD. The outpatient videos were recorded before and after medication treatment. Statistical analysis indicated that four features corresponding to the first autocorrelation coefficients of the original series of four skeleton parameters and 11 features each corresponding to the first autocorrelation coefficients of the differenced series and the averaged variances of the original series of 11 skeleton parameters significantly decreased after the use of methylphenidate, an ADHD medication. The results revealed that the proposed approach can support physicians as an objective and automatic tool for evaluating the therapeutic effects of medication on patients with ADHD.


2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Scott H. Kollins ◽  
Ann Childress ◽  
Andrew C. Heusser ◽  
Jacqueline Lutz

AbstractSTARS-Adjunct was a multicenter, open-label effectiveness study of AKL-T01, an app and video-game-based treatment for inattention, as an adjunct to pharmacotherapy in 8–14-year-old children with attention-deficit/hyperactivity disorder (ADHD) on stimulant medication (n = 130) or not on any ADHD medication (n = 76). Children used AKL-T01 for 4 weeks, followed by a 4-week pause and another 4-week treatment. The primary outcome was change in ADHD-related impairment (Impairment Rating Scale (IRS)) after 4 weeks. Secondary outcomes included changes in IRS, ADHD Rating Scale (ADHD-RS). and Clinical Global Impressions Scale—Improvement (CGI-I) on days 28, 56, and 84. IRS significantly improved in both cohorts (On Stimulants: −0.7, p < 0.001; No Stimulants: −0.5, p < 0.001) after 4 weeks. IRS, ADHD-RS, and CGI-I remained stable during the pause and improved with a second treatment period. The treatment was well-tolerated with no serious adverse events. STARS-Adjunct extends AKL-T01’s body of evidence to a medication-treated pediatric ADHD population, and suggests additional treatment benefit.


2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1
Author(s):  
A. Malekian ◽  
Z. Amini ◽  
M. Barekatain ◽  
M.R. Maracy ◽  
G. Ahmadzadeh

Despite the wide consensus over the safety and efficacy of electroconvulsive therapy (ECT), it still faces unfavorable attitudes of patients and families. Little is known about how the experience with ECT affects the patients’ and their families’ attitude toward it. This study examined a sample of Iranian patients and their families regarding their experience with ECT and compared their knowledge and attitude toward ECT before and after this experience and their satisfaction with it. We surveyed 22 patients with major depressive disorder about to undergo ECT and 1 family member of each patient for their knowledge and attitude toward ECT and then surveyed them again after the trial of ECT to compare those variables while assessing their experience and satisfaction with ECT. Patients were rated using the Hamilton Depression Rating Scale and Mini-Mental Status Examination before and after the treatment. Before ECT, family members had a more favorable attitude toward ECT than patients, but after ECT, the patients’ attitude changed more positively. Both patients and their families had a poor knowledge of ECT before the ECT trial, but their total knowledge increased afterward, although not in the areas of indications and therapeutic effects. The majority of patients and their families found ECT to be beneficial and were satisfied with it. There was a high rate of perceived coercion to consent to ECT. Attention should be paid toward educating patients and their families about the ECT as well as informing them about their freedom of choice and right to refuse.


2020 ◽  
Author(s):  
Jørn Henrik Vold ◽  
Christer Aas ◽  
Svetlana Skurtveit ◽  
Ingvild Odsbu ◽  
Fatemeh Chalabianloo ◽  
...  

Abstract Background It is estimated that up to a third of patients on opioid agonist therapy (OAT) have attention deficit hyperactivity disorder (ADHD). Treatment by ADHD medication, including a centrally acting stimulant (CAS) or atomoxetine is one of the essential approaches. This study evaluates the use of dispensed ADHD medications in the Norwegian OAT population in the period from 2015 to 2017. Types and doses of ADHD medications, co-dispensations of other potentially addictive drugs like benzodiazepines, z-hypnotics, gabapentinoids, and non-OAT opioids, as well as direct-acting antivirals (DAA) against hepatitis C infection, are investigated. Methods Information about all dispensed ADHD medication, OAT opioids, and the defined potentially addictive drugs were recorded from the Norwegian Prescription Database. Dispensation rates, the types, and the doses of dispensed ADHD medications were estimated by summarizing the number of dispensations, and the dispensed doses. Logistic regression analyses were employed to assess the associations between ADHD medication, and OAT opioid use, and dispensations of other potentially addictive drugs and DAAs against hepatitis C infection. Results A total of 9,235 OAT patients were included. The proportion of patients who were dispensed ADHD medication increased from 3.5% to 4.6% throughout the study period. The three most dispensed CAS were short- and intermediate-acting methylphenidate (55%), lisdexamphetamine (24%), and dexamphetamine (17%) in 2017. Buprenorphine, rather than methadone, as OAT opioid (adjusted odds ratio: 1.6, CI: 1.2-2.1) was associated with being dispensed ADHD medication. Among patients who received CAS and OAT opioids each calendar year, the dispensed doses of methylphenidate increased from 63 mg/day in 2015 to 76 mg/day in 2017 (p = 0.01). Eighty-five of 142 patients receiving ADHD medications were also dispensed other addictive drugs concomitantly in 2017. Similar results were found in 2015 and 2016. Conclusion Co-prescription of ADHD medications was low among patients on OAT in Norway, considering a high prevalence of ADHD in this patient group. On the other hand, concurrent dispensations of multiple addictive drugs were common in this population. Understanding the underlying reasons for such prescribing is essential, and research on how to optimize ADHD medication of patients with ADHD receiving OAT is needed.


2021 ◽  
Vol 11 (12) ◽  
pp. 5478
Author(s):  
Rei-Cheng Yang ◽  
Rong-Ching Wu ◽  
Ching-Tai Chiang ◽  
Yi-Hung Chiu ◽  
Chen-Sen Ouyang ◽  
...  

Attention-deficit hyperactivity disorder (ADHD) is the most common neuropsychiatric disorder in schoolchildren. Several methods are available to evaluate ADHD therapeutic effects, including the Swanson, Nolan, and Pelham (SNAP) questionnaire, the Vanderbilt ADHD Diagnostic Rating Scale, and the visual analog scale. However, these scales are subjective. In this study, a piezoelectric material was applied to a medical chair to objectively evaluate the therapeutic effect of ADHD medication before and after treatment. A total of 22 patients (18 boys and 4 girls) with ADHD were enrolled. During the appointment, the patients’ movements were recorded by the piezoelectric material before being analyzed. The variance, zero-crossing rate, and high energy rate of movements were used to analyze the signal in this study. The results showed the variance, zero-crossing rate, and high energy rate in patients with ADHD all decreased significantly after 1 month of methylphenidate use. Although the hyperactivity subscales of SNAP obtained from parents and teachers demonstrated significant decreases after 1 month of medication, the reduction rate of the three aforementioned measurements decreased more than hyperactivity subscales. This suggests that the use of a smart chair equipped with a piezoelectric material is an objective and useful method for evaluating the therapeutic effects of ADHD medication.


Author(s):  
Danielle Wilson ◽  
Lisa Riches

Rationale, aims & objectives: This evaluation was carried out in order to determine the efficacy of the Norfolk and Waveney Adult ADHD Service. With the service not commissioned to offer non-pharmacological support, and with a gap in the research literature, evidence on whether the service model was effective at reducing the impact of ADHD symptoms on service users was needed in order to justify longer term commissioning. Method: Case notes of 113 individuals going through their medication titration process were observed. Scores from the Weiss Functional Impairment Rating Scale (WFIRS), which was routinely collected in the service pre- and post- titration onto ADHD medication, were recorded for comparison. Results: A T test revealed significant improvements in functioning across all domains of the WFIRS after successful titration onto ADHD medication. However, 19.5% of the sample disengaged from the service prior to completing titration. A further 12.5% of the sample did not complete titration due to various factors discussed. Conclusion: While medication has been shown to be effective at improving impairment of functioning in adults with ADHD, high levels of disengagement suggest that more needs to be offered to this population.


2020 ◽  
Author(s):  
Jørn Henrik Vold ◽  
Christer Aas ◽  
Svetlana Skurtveit ◽  
Ingvild Odsbu ◽  
Fatemeh Chalabianloo ◽  
...  

Abstract Background It is estimated that up to a third of patients on opioid agonist therapy (OAT) have attention deficit hyperactivity disorder (ADHD). Treatment by ADHD medication, including a centrally acting stimulant (CAS) or atomoxetine is one of the essential approaches. This study evaluates the use of dispensed ADHD medications in the Norwegian OAT population in the period from 2015 to 2017. Types and doses of ADHD medications, co-dispensations of other potentially addictive drugs like benzodiazepines, z-hypnotics, gabapentinoids, and non-OAT opioids, as well as direct-acting antivirals (DAA) against hepatitis C infection, are investigated. Methods Information about all dispensed ADHD medication, OAT opioids, and the defined potentially addictive drugs were recorded from the Norwegian Prescription Database. Dispensation rates, the types, and the doses of dispensed ADHD medications were estimated by summarizing the number of dispensations, and the dispensed doses. Logistic regression analyses were employed to assess the associations between ADHD medication, and OAT opioid use, and dispensations of other potentially addictive drugs and DAAs against hepatitis C infection. Results A total of 9,235 OAT patients were included. The proportion of patients who were dispensed ADHD medication increased from 3.5% to 4.6% throughout the study period. The three most dispensed CAS were short-acting methylphenidate (55%), lisdexamphetamine (24%), and dexamphetamine (17%) in 2017. Buprenorphine, rather than methadone, as OAT opioid (adjusted odds ratio: 1.6, CI: 1.2-2.1) was associated with being dispensed ADHD medication. Among patients who received CAS and OAT opioids each calendar year, the dispensed doses of methylphenidate increased from 63 mg/day in 2015 to 76 mg/day in 2017 (p = 0.01). Sixty percent of patients receiving ADHD medications were also dispensed other addictive drugs concomitantly in 2017. Similar results were found in 2015 and 2016. Conclusion Co-prescription of ADHD medications was low among patients on OAT in Norway, considering a high prevalence of ADHD in this patient group. On the other hand, concurrent dispensations of multiple addictive drugs were common in this population. Understanding the underlying reasons for such prescribing is essential, and research on how to optimize ADHD medication of patients with ADHD receiving OAT is needed.


PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252420
Author(s):  
Yoshinori Sasaki ◽  
Noa Tsujii ◽  
Shouko Sasaki ◽  
Hikaru Sunakawa ◽  
Yusuke Toguchi ◽  
...  

Background/aim Patients with attention-deficit hyperactivity disorder (ADHD) manifest symptoms of hyperactivity, impulsivity, and/or inattention. ADHD medications available in Japan are limited compared with those in Western countries. Prescribing status has not been sufficiently evaluated in clinical settings in Japan. This study investigated the current use of ADHD medications and characteristics of patients who received multiple ADHD medications in a clinical setting in Japan. Methods Study participants were those who visited the Department of Child and Adolescent Psychiatry, Kohnodai Hospital between April 2015 and March 2020. We investigated patients who received osmotic-controlled release oral delivery system methylphenidate, atomoxetine, or guanfacine. A retrospective case–control design was used to evaluate the characteristics of patients who received multiple ADHD medications. Patients who were given three ADHD medications were defined as the case group. Randomly sampled sex- and age-matched patients diagnosed with ADHD were defined as the control group. We compared data for child-to-parent violence, antisocial behavior, suicide attempt or self-harm, abuse history, refusal to attend school, and two psychological rating scales (the ADHD-Rating Scale and Tokyo Autistic Behavior Scale). Results Among the 878 patients who were prescribed any ADHD medications, 43 (4.9%) received three ADHD medications. Logistic regression revealed that children with severe ADHD symptoms, autistic characteristics, or tendency of child-to-parent violence were more likely to have been prescribed three medications during their treatment. Conclusions Our findings suggest the approach to prevent the use of multiple ADHD medications. A prospective study to investigate the causality between prescribing status and clinical characteristics is warranted.


2020 ◽  
pp. 1-6
Author(s):  
Paul Park ◽  
Victor Chang ◽  
Hsueh-Han Yeh ◽  
Jason M. Schwalb ◽  
David R. Nerenz ◽  
...  

OBJECTIVEIn 2017, Michigan passed new legislation designed to reduce opioid abuse. This study evaluated the impact of these new restrictive laws on preoperative narcotic use, short-term outcomes, and readmission rates after spinal surgery.METHODSPatient data from 1 year before and 1 year after initiation of the new opioid laws (beginning July 1, 2018) were queried from the Michigan Spine Surgery Improvement Collaborative database. Before and after implementation of the major elements of the new laws, 12,325 and 11,988 patients, respectively, were treated.RESULTSPatients before and after passage of the opioid laws had generally similar demographic and surgical characteristics. Notably, after passage of the opioid laws, the number of patients taking daily narcotics preoperatively decreased from 3783 (48.7%) to 2698 (39.7%; p < 0.0001). Three months postoperatively, there were no differences in minimum clinically important difference (56.0% vs 58.0%, p = 0.1068), numeric rating scale (NRS) score of back pain (3.5 vs 3.4, p = 0.1156), NRS score of leg pain (2.7 vs 2.7, p = 0.3595), satisfaction (84.4% vs 84.7%, p = 0.6852), or 90-day readmission rate (5.8% vs 6.2%, p = 0.3202) between groups. Although there was no difference in readmission rates, pain as a reason for readmission was marginally more common (0.86% vs 1.22%, p = 0.0323).CONCLUSIONSThere was a meaningful decrease in preoperative narcotic use, but notably there was no apparent negative impact on postoperative recovery, patient satisfaction, or short-term outcomes after spinal surgery despite more restrictive opioid prescribing. Although the readmission rate did not significantly increase, pain as a reason for readmission was marginally more frequently observed.


2019 ◽  
pp. 85-91
Author(s):  
Dinh Duong Le ◽  
Van Thang Vo ◽  
Thi Mai Nguyen ◽  
Thi Han Vo ◽  
Huu Chau Duc Nguyen ◽  
...  

Objectives: The study aims to explore the prevalence of attention deficit hyperactivity disorder and to examine the associated factors with ADHD among primary students by Vanderbilt ADHD rating scale for teacher and parents. Methods: A cross-sectional study design was conducted in 564 students who selected randomly in 4 primary schools in Hue city. Vanderbilt ADHD rating scale for parents and teachers were applied to evaluate the ADHD of children over 6 months ago. Results: The overall prevalence of children who had high risk with ADHD was 4.1% (95%CI: 2.44 - 5.72), including 4.6% and 4.8% in the rating of teachers and parents, respectively. Male was more likely to have ADHD than female (OR adj: 4.64 (95%CI: 1.53 - 14.05) and lack of closely friend (OR adj: 5.11 (95% CI: 2.13 - 12.24). Conclusion: Vanderbilt ADHD diagnosis rating scale for teachers and parents can be used to early recognization children with a high risk of ADHD. Key words: ADHD, Vanderbilt, ratings scale, teacher, parent, children


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