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Ann Gen Psychiatry. 2006 Apr 10;5:5. doi: 10.1186/1744-859X-5-5.

Impact of methylphenidate formulation on treatment patterns and hospitalizations: a retrospective analysis.

Annals of general psychiatry

Jason E Kemner, Maureen J Lage

Affiliations

  1. McNeil Consumer and Specialty Pharmaceuticals, Fort Washington PA 19034, USA. [email protected]

PMID: 16606463 PMCID: PMC1462992 DOI: 10.1186/1744-859X-5-5

Abstract

BACKGROUND: While stimulant therapy has been shown to be effective in the treatment of attention-deficit/hyperactivity disorder (ADHD), there is less information concerning differences between alternative stimulant medications. The purpose of this study is to examine how different formulations of methylphenidate (MPH) affect treatment patterns and hospitalizations.

METHODS: From a large claims database we retrospectively identified individuals age 6 or older who were diagnosed with ADHD and who received either once daily, extended-release oral system methylphenidate (OROS MPH) (e.g., Concerta) or three-times daily immediate-release generic methylphenidate (TID MPH). There were 5,939 individuals included in the analysis--4,785 who initiated therapy with OROS MPH and 1,154 who initiated therapy with TID MPH. We used Analyses of Covariance (ANCOVAs) to examine differences in treatment patterns between individuals who initiated therapy on OROS MPH and those who initiated therapy on TID MPH. We used logistic and negative binomial multivariate regressions to examine the probability of being hospitalized and the hospital length of stay.

RESULTS: Controlling for demographic characteristics, patient general health status, and comorbid diagnoses, significantly fewer individuals who initiated therapy with OROS MPH had a 15-day gap in therapy (85% vs. 97%, p < 0.0001 or a 30-day gap in therapy (77% vs. 95%, p < 0.0001) or switched to another ADHD medication (27% vs. 68%, p < 0.0001). Individuals who initiated therapy with OROS MPH stayed on therapy significantly longer (199 vs. 108 mean days, p < 0.0001) and more individuals received medication for 90% (24% vs. 5%, p < 0.0001), 80% (29% vs. 7%, p < 0.0001), or 75% (30% vs. 7%, p < 0.0001) of the days during the first year post initiation of therapy. Individuals who initiated therapy on OROS MPH were also significantly less likely to be hospitalized (odds ratio = 0.67, p = 0.0454) and stayed, on average, 0.69 fewer days in the hospital (p = 0.0035).

CONCLUSION: Results demonstrate that among individuals diagnosed with ADHD who receive either OROS MPH or TID MPH, the use of OROS MPH is associated with fewer gaps in medication, less switches in medication, and more days on intent-to-treat therapy. In addition, use of OROS MPH compared to TID MPH was associated with improved outcomes, as measured by the reduced use of hospitalizations.

References

  1. J Child Adolesc Psychopharmacol. 1992 Winter;2(4):267-75 - PubMed
  2. J Clin Psychiatry. 2004;65 Suppl 3:3-7 - PubMed
  3. Pediatrics. 1993 Aug;92(2):212-8 - PubMed
  4. JAMA. 2001 Jan 3;285(1):60-6 - PubMed
  5. J Child Psychol Psychiatry. 2004 Feb;45(2):195-211 - PubMed
  6. Biol Psychiatry. 2003 Dec 15;54(12):1465-8 - PubMed
  7. Compr Psychiatry. 1996 Nov-Dec;37(6):393-401 - PubMed
  8. Pediatrics. 1996 Dec;98(6 Pt 1):1089-95 - PubMed
  9. Psychiatry Res. 1996 Jun 1;62(3):213-9 - PubMed
  10. J Am Acad Child Adolesc Psychiatry. 2003 Dec;42(12):1415-23 - PubMed
  11. J Atten Disord. 2002 Sep;6(2):77-82 - PubMed
  12. Pediatrics. 1998 Dec;102(6):1415-21 - PubMed
  13. J Int Neuropsychol Soc. 2002 Jul;8(5):655-72 - PubMed
  14. Ann N Y Acad Sci. 2001 Jun;931:216-38 - PubMed
  15. J Pediatr Psychol. 2004 Mar;29(2):119-30 - PubMed
  16. J Manag Care Pharm. 2004 Mar-Apr;10(2):122-9 - PubMed
  17. Clin Ther. 2001 Aug;23(8):1296-310 - PubMed
  18. Am J Psychiatry. 1999 Oct;156(10):1664-5 - PubMed
  19. Pediatrics. 2001 Oct;108(4):1033-44 - PubMed
  20. J Am Acad Child Adolesc Psychiatry. 2004 May;43(5):559-67 - PubMed
  21. CNS Drugs. 2003;17(2):117-31 - PubMed
  22. Curr Opin Pediatr. 2004 Apr;16(2):217-26 - PubMed
  23. Hum Psychopharmacol. 2002 Jul;17(5):225-31 - PubMed
  24. Biol Psychiatry. 1998 Aug 15;44(4):260-8 - PubMed
  25. Ann N Y Acad Sci. 2001 Jun;931:1-16 - PubMed
  26. Pediatrics. 2000 May;105(5):1158-70 - PubMed
  27. J Child Adolesc Psychopharmacol. 2001 Spring;11(1):59-67 - PubMed
  28. Am J Psychiatry. 1993 Dec;150(12):1792-8 - PubMed
  29. Compr Psychiatry. 1990 Sep-Oct;31(5):416-25 - PubMed
  30. Burns. 2004 Mar;30(2):148-50 - PubMed

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