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Optimising medication management in children and young people with ADHD using a computerised test (QbTest): a feasibility randomised controlled trial

Williams, Laura; Hall, Charlotte L.; Brown, Sue; Guo, Boliang; James, Marilyn; Franceschini, Matilde; Clarke, Julie; Selby, Kim; Vijayan, Hena; Kulkarni, Neeta; Brown, Nikki; Sayal, Kapil; Hollis, Chris; Groom, Madeleine J.

Optimising medication management in children and young people with ADHD using a computerised test (QbTest): a feasibility randomised controlled trial Thumbnail


Authors

Laura Williams

BOLIANG GUO BOLIANG.GUO@NOTTINGHAM.AC.UK
Associate Professor

MARILYN JAMES MARILYN.JAMES@NOTTINGHAM.AC.UK
Professor of Health Economics

Matilde Franceschini

Julie Clarke

Kim Selby

Hena Vijayan

Neeta Kulkarni

Nikki Brown

KAPIL SAYAL kapil.sayal@nottingham.ac.uk
Professor of Child and Adolescent Psychiatry

CHRIS HOLLIS chris.hollis@nottingham.ac.uk
Professor of Child and Adolescent Psychiatry and Digital Mental Health



Abstract

Background
Medication for attention deficit hyperactivity disorder (ADHD) should be closely monitored to ensure optimisation. There is growing interest in using computerised assessments of ADHD symptoms to support medication monitoring. The aim of this study was to assess the feasibility and acceptability of a randomised controlled trial (RCT) to evaluate the efficacy of one such computerised assessment, the Quantified Behavior (Qb) Test, as part of medication management for ADHD.

Methods
This feasibility multi-site RCT conducted in child and adolescent mental health and community paediatric settings recruited participants aged 6–15 years diagnosed with ADHD starting stimulant medication. Participants were randomised into one of two arms: experimental (QbTest protocol) where participants completed a QbTest at baseline and two follow-up QbTests on medication (2–4 weeks and 8–10 weeks later) and control where participants received treatment as usual, including at least two follow-up consultations. Measures of parent, teacher, and clinician-rated symptoms and global functioning were completed at each time point. Clinicians recorded treatment decision-making and health economic measures were obtained. Data were analysed using multi-level modelling and participants (children and parents) and clinicians were interviewed about their experiences, resulting data were thematically analysed.

Results
Forty-four children and young people were randomised. Completion of study outcome measures by care-givers and teachers ranged from 52 to 78% at baseline to 47–65% at follow-up. Participants reported the questionnaires to be useful to complete. SNAP-IV inattention scores showed greater reduction in the intervention than the control group (− 5.85, 95% CI − 10.33, − 1.36,). Engagement with the intervention ranged from 100% at baseline, to 78% follow-up 1 and 57% follow-up 2. However, only 37% of QbTests were conducted in the correct time period. Interview data highlighted that the objectivity of the QbTest was appreciated by clinicians and parents. Clinicians commented that the additional time and resources required meant that it is not feasible to use QbTest for all cases.

Conclusion
The trial design and protocol appear to be feasible and acceptable but could be improved by modifying QbTest time periods and the method of data collection. With these changes, the protocol may be appropriate for a full trial. Adding QbTest may improve symptom outcome as measured by SNAP-IV.

Citation

Williams, L., Hall, C. L., Brown, S., Guo, B., James, M., Franceschini, M., …Groom, M. J. (2021). Optimising medication management in children and young people with ADHD using a computerised test (QbTest): a feasibility randomised controlled trial. Pilot and Feasibility Studies, 7, Article 68. https://doi.org/10.1186/s40814-021-00788-1

Journal Article Type Article
Acceptance Date Jan 29, 2021
Online Publication Date Mar 16, 2021
Publication Date Mar 16, 2021
Deposit Date Mar 23, 2021
Publicly Available Date Mar 29, 2024
Journal Pilot and Feasibility Studies
Print ISSN 2055-5784
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 7
Article Number 68
DOI https://doi.org/10.1186/s40814-021-00788-1
Public URL https://nottingham-repository.worktribe.com/output/5412599
Publisher URL https://pilotfeasibilitystudies.biomedcentral.com/articles/10.1186/s40814-021-00788-1

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