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A comparison of the clinical effectiveness and cost of specialised individually-delivered parent training for preschool attention-deficit/hyperactivity disorder and a generic, group-based programme: a multi-centre, randomised controlled trial of the New F

Sonuga-Barke, Edmund J.S.; Barton, Joanne; Daley, David; Hutchings, Judy; Maishman, Tom; Raftery, James; Stanton, Louise; Bradbury, Cathy Laver; Chorozoglou, Maria; Coghill, David; Little, Louise; Ruddock, Martin; Radford, Mike; Yao, Guiqing; Lee, Louise; Gould, Lisa; Shipway, Lisa; Markomichali, Pavlina; McGuirk, James; Lowe, Michelle; Vallejos, Elvira Perez; Lockwood, Joanna; Thompson, Margaret J.J.

Authors

Edmund J.S. Sonuga-Barke

Joanne Barton

David Daley

Judy Hutchings

Tom Maishman

James Raftery

Louise Stanton

Cathy Laver Bradbury

Maria Chorozoglou

David Coghill

Louise Little

Martin Ruddock

Mike Radford

Guiqing Yao

Louise Lee

Lisa Gould

Lisa Shipway

Pavlina Markomichali

James McGuirk

Michelle Lowe

Elvira Perez Vallejos

Joanna Lockwood

Margaret J.J. Thompson



Abstract

Objective: To compare the efficacy and cost of specialised individually-delivered parent training (PT) for preschool children with attention-deficit/ hyperactivity disorder (ADHD) against generic group-based PT and treatment as usual (TAU). Design: Multi-centre, three-arm parallel group randomised controlled trial. Research Setting: National Health Service Trusts. Participants: Preschool children (33-54 months) fulfilling ADHD research diagnostic criteria. Interventions: New Forest Parenting Programme (NFPP) – 12 week individual, home-delivered ADHD PT programme; Incredible Years (IY) – 12 week group-based, PT programme initially designed for children with behaviour problems. Main outcome measures: Primary outcome - Parent ratings of child’s ADHD symptoms (Swanson, Nolan & Pelham Questionnaire - SNAP-IV). Secondary outcomes - teacher ratings (SNAP-IV) and direct observations of ADHD symptoms and parent/teacher ratings of conduct problems. NFPP, IY and TAU outcomes were measured at baseline (T1) and post-treatment (T2). NFPP and IY outcomes only were measured 6 months post treatment (T3). Researchers, but not therapists or parents, were blind to treatment allocation. Analysis employed mixed effect regression models (multiple imputation). Intervention and other costs were estimated using standardized approaches. Results: NFPP and IY did not differ on parent-rated SNAP-IV, ADHD combined symptoms (mean difference -0.009 95%CI [-0.191, 0.173], p=0.921) or any other measure. Small, non-significant, benefits of NFPP over TAU were seen for parent-rated SNAP-IV, ADHD combined symptoms (-0.189 95%CI [-0.380, 0.003], p=0.053). NFPP significantly reduced parent-rated conduct-problems compared to TAU across scales (p-values.05). The cost per family of providing NFPP in the trial was significantly lower than IY (£1,591 versus £2,103).
Conclusions: Although, there were no differences between NFPP and IY with regards clinical effectiveness, individually-delivered NFPP cost less. However, this difference may be reduced when implemented in routine clinical practice. Clinical decisions should take into account parental preferences between delivery approaches.
Funding: National Institute of Health Research.
Trial Registration: Trial name: COPPI Trial; ISRCTN39288126.

Journal Article Type Article
Publication Date Jun 30, 2018
Journal European Child & Adolescent Psychiatry
Print ISSN 1018-8827
Electronic ISSN 1435-165X
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 27
Issue 6
Pages 797-809
APA6 Citation Sonuga-Barke, E. J., Barton, J., Daley, D., Hutchings, J., Maishman, T., Raftery, J., …Thompson, M. J. (2018). A comparison of the clinical effectiveness and cost of specialised individually-delivered parent training for preschool attention-deficit/hyperactivity disorder and a generic, group-based programme: a multi-centre, randomised controlled trial of the New Forest Parenting Programme versus Incredible Years. European Child and Adolescent Psychiatry, 27(6), (797-809). doi:10.1007/s00787-017-1054-3. ISSN 1018-8827
DOI https://doi.org/10.1007/s00787-017-1054-3
Publisher URL https://link.springer.com/article/10.1007/s00787-017-1054-3
Copyright Statement Copyright information regarding this work can be found at the following address: http://eprints.nottingh.../end_user_agreement.pdf
Additional Information The final publication is available at Springer via http://dx.doi.org/10.1007/s00787-017-1054-3

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