Social adjustment and family function after drug switch from IR-methylphenidate to OROS-methylphenidate in patients with attention-deficit/hyperactivity disorder

Figures & data

Table 1 Baseline patient characteristics

Characteristics	N=296
Age, years
<9	86 (29.05)
9–12	129 (43.58)
>12	81 (27.36)
Sex
Male	247 (83.45)
Female	49 (16.55)
Educational level of patient’s father
College or above	99 (33.45)
Senior high school	139 (46.96)
Junior high school or lower	48 (16.22)
Missing	10 (3.38)
Educational level of patient’s mother
College or above	77 (26.01)
Senior high school	170 (57.43)
Junior high school or lower	40 (13.51)
Missing	9 (3.04)
ADHD subtypes
Hyperactive/impulsive or combined type	204 (68.91)
Predominantly inattentive type	90 (30.41)
Missing	2 (0.68)
Comorbidity
Oppositional defiant disorder	15 (5.07)
Conduct disorder	3 (1.01)
Anxiety disorders	5 (1.69)
Depressive disorders	2 (0.68)
Tic disorders	6 (2.03)
Intellectual disability	13 (4.39)
Frequency of preceding administration of IR-MPH
Once daily	61 (20.61)
Twice daily	191 (64.53)
Thrice daily	43 (14.53)
Other	1 (0.34)
Dose of the preceding IR-MPH treatment (mg/day), mean (SD)	19.8 (8.60)
Drug adherence with IR-MPH
Good	157 (53.95)
Poor	132 (45.36)
Drug adherence with OROS-MPH
Good	170 (58.42)
Poor	86 (29.55)

Note: Data are n (%) unless specified otherwise.

Abbreviations: ADHD, attention-deficit/hyperactivity disorder; IR-MPH, immediate-release methylphenidate; OROS-MPH, osmotic controlled-release formulation of methylphenidate.

Table 2 Changes in clinical symptoms, social adjustment, and parents’ mental health status for patients with ADHD during the 8-week treatment with osmotic controlled-release formulation of methylphenidate

	Visit 1 (baseline)	Visit 2 (week 2)	Visit 3 (week 4)	Visit 4 (week 8)	Statisticsa
	Mean±SD	Mean±SD	Mean±SD	Mean±SD	B	P-value	Post hoc test
SNAP-IV parent form
Inattention	15.3±5.5	11.5±5.3	10.7±4.9	10.3±4.8	−1.57	<0.001b	V1>V2≈V3>V4
Hyperactivity/impulsivity	12.7±6.3	9.5±6.2	9.0±6.0	8.1±5.3	−1.40	<0.001b	V1>V2≈V3>V4
Oppositional	10.6±5.9	8.0±5.5	7.4±5.3	6.9±4.7	−1.12	<0.001b	V1>V2≈V3>V4
Total scores	38.5±15.2	29.0±15.0	27.1±14.3	25.3±13.1	−4.09	<0.001b	V1>V2≈V3>V4
SNAP-IV teacher form
Inattention	13.2±5.9	11.4±5.9	10.3±5.6	10.3±5.8	−1.02	<0.001b	V1>V2>V3≈V4
Hyperactivity/impulsivity	9.7±6.7	8.1±6.6	7.6±6.8	7.2±6.3	−0.78	<0.001b	V1>V2≈V3≈V4
Oppositional	7.0±6.0	5.8±5.9	5.1±5.5	5.1±5.4	−0.64	<0.001b	V1>V2≈V3≈V4
Total scores	30.0±16.0	25.4±16.3	23.0±16.0	22.3±15.3	−2.55	<0.001b	V1>V2>V3≈V4
CGI-Severity	4.3±0.9	3.4±1.0	3.0±1.0	3.0±1.1	−0.45	<0.001b	V1>V2>V3≈V4
CGI-Improvement	–	3.0±1.0	2.7±1.0	2.7±1.1	−0.12	<0.001b	V2>V3≈V4
SAICA
School	43.3±10.6	–	38.4±9.3	37.9±9.8	−1.79	<0.001b	V1>V3≈V4
Spare time	39.4±8.9	–	39.7±7.7	39.1±7.6	0.03	<0.001b	–
Peer relationship	32.9±8.5	–	31.2±7.3	30.7±7.3	−0.71	<0.001b	V1>V3≈V4
Home behavior	39.7±10.1	–	37.2±8.8	37.4±9.3	−0.71	<0.001b	V1>V3≈V4
Total	156.6±28.8	–	146.1±23.8	144.7±23.9	−3.31	<0.001b	V1>V3≈V4
CHQ-mother	22.7±6.9	–	20.8±4.9	21.1±5.3	−0.52	<0.001b	V1>V3≈V4
APGAR-mother	6.5±2.9	–	6.8±2.8	6.6±3.0	0.04	0.693	–

Notes:

a Statistical analyses used general linear model, followed by a post hoc least significant difference test.

b Value meets the P<0.05 criterion.

Abbreviations: ADHD, attention-deficit/hyperactivity disorder; APGAR, Adaptation, Partnership, Growth, Affection, and Resolve; B, beta coefficient examined by multivariate linear regression model; CGI, Clinical Global Impression; CHQ, Chinese Health Questionnaire; SAICA, Social Adjustment Inventory for Children and Adolescents; SNAP-IV, Swanson, Nolan, and Pelham version IV; V, visit.

Table 3 Factors associated with changes in ADHD symptoms, social function, and mothers’ mental health status in patients with ADHD after switching from immediate-release to osmotic controlled-release formulation of methylphenidate

	SNAP-IV parent form (total scores)		SNAP-IV teacher form (total scores)		SAICA (total scores)		CHQ completed by
	B	P-value	B	P-value	B	P-value	B	P-value
Age	−0.100	0.764	−0.511	0.151	−0.159	0.633	−0.182	0.192
Sex
Male	1		1		1		1
Female	−0.604	0.776	0.905	0.692	0.308	0.885	−0.735	0.399
ADHD subtypes
Predominantly inattentive type	1		1		1		1
H/C type	2.045	0.240	−0.269	0.884	−1.215	0.485	0.218	0.762
Intellectual disability
Without	1		1		1		1
With	6.468	0.078	3.666	0.377	−0.894	0.807	3.229	0.058
Adherence to previous
IR-MPH treatment
Good	1		1		1		1
Poor	−1.249	0.424	−3.611	0.031a	1.905	0.223	−1.419	0.030a
Frequency of previous
IR-MPH administration
Once daily	1		1		1		1
Twice daily	−0.989	0.610	−0.196	0.925	−2.563	0.185	0.418	0.607
Thrice daily	−0.498	0.854	−0.072	0.980	−5.064	0.061	0.540	0.630

Note:

a Value meets the P<0.05 criterion.

Abbreviations: ADHD, attention-deficit/hyperactivity disorder; B, examined by multivariate linear regression model; CHQ, Chinese Health Questionnaire; H/C type, hyperactive/impulsive or combined type; IR-MPH, immediate-release methylphenidate; SAICA, Social Adjustment Inventory for Children and Adolescents; SNAP-IV, Swanson, Nolan, and Pelham, version IV.

Table S1 Number of available assessments at each visit

Assessments	Number of available assessments				% of available assessments
	Visit 1 (baseline)	Visit 2	Visit 3	Visit 4	Visit 1 (baseline)	Visit 2	Visit 3	Visit 4
SNAP-IV (parents)
Inattention	293	296	296	296	99.0	100.0	100.0	100.0
Hyperactivity	293	295	295	295	99.0	99.7	99.7	99.7
Oppositional	296	296	296	296	100.0	100.0	100.0	100.0
SNAP-IV (teachers)
Inattention	281	286	287	287	94.9	96.6	97.0	97.0
Hyperactivity	285	287	288	288	96.3	97.0	97.3	97.3
Oppositional	283	286	287	287	95.6	96.6	97.0	97.0
CHQ scores
Mother	275	–	280	281	92.9	–	94.6	94.9
Father	216	–	222	225	73.0	–	75.0	76.0
APGAR-C scores
Mother	275	–	280	281	92.9	–	94.6	94.9
Father	216	–	223	226	73.0	–	75.3	76.4
SAICA subscores
School	291	–	293	293	98.3	–	99.0	99.0
Spare time	291	–	293	293	98.3	–	99.0	99.0
Peer relationships	293	–	294	294	99.0	–	99.3	99.3
Home behavior	295	–	295	295	99.7	–	99.7	99.7
CGI-S	290	291	291	292	98.0	98.3	98.3	98.6
CGI-I	–	292	262	282	–	98.6	88.5	95.3

Abbreviations: APGAR-C, Adaptation, Partnership, Growth, Affection, and Resolve-Chinese version; CGI-I, Clinical Global Impression-Improvement; CGI-S, Clinical Global Impression-Severity; CHQ, Chinese Health Questionnaire; SAICA, Social Adjustment Inventory for Children and Adolescents; SNAP-IV, Swanson, Nolan, and Pelham version IV.