Individual treatment response in attention-deficit/hyperactivity disorder: broadening perspectives and improving assessments

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a highly complex disorder with multiple treatment options. Impairments associated with ADHD, rather than symptoms defining the disorder, are the primary reason for referral of individuals to clinical services; consequently, they should also be key targets for intervention. Impairments are moderated by factors such as comorbidities, family environment and intelligence quotient, and particular challenges may vary between patients. The understanding of patient and family treatment preferences, as well as identification of treatment needs and goals, should drive future clinical practice. This review addresses the assessment of ADHD treatment goals and outcomes in clinical practice, and discusses changes in future clinical research studies necessary to progress the utilization of an individualized medicine approach in ADHD.

Keywords::

• adaptive clinical trial
• ADHD
• functional impairment
• health-related quality of life
• individualized medicine
• patient-reported outcome
• treatment

Financial & competing interests disclosure

P Hodgkins is employed by Shire Development, LLC. S Sorooshian is employed by Shire AG. Shire develops and manufactures treatments for psychiatric disorders including ADHD. RW Dittmann is a former employee of Eli Lilly & Co. and owner of Eli Lilly stock; he currently holds the Eli Lilly & Co. Endowed Chair of Pediatric Psychopharmacology at the CIMH Mannheim, Germany. He has served in an advisory or consultancy role for Janssen-Cilag, Lilly and Shire. He has received conference attendance support or received speaker’s fees from Lilly and Shire. He is or has been involved in clinical trials conducted by Ferring, Janssen-Cilag, Lilly, Otsuka and Shire. The present work is unrelated to the above relationships and grants. T Banaschewski has served in an advisory or consultancy role for Bristol-Myers Squibb, Develco Pharma, Lilly, Medice, Novartis, Shire and Vifor Pharma. He has received conference attendance support, conference support or speaker’s fees from Lilly, Janssen McNeil, Medice, Novartis and Shire. He is or has been involved in clinical trials conducted by Lilly and Shire. The present work is unrelated to the above grants and relationships. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Shire AG (Switzerland) provided funding to Caudex Medical Oxford, UK for support in writing and editing of this manuscript. Under the direction of the authors, Alyson Bexfield, PhD (Caudex Medical, Oxford, UK) provided writing assistance for this manuscript.