Concern Is Not With Growth but Efficacy
The study is a continuation of the Multimodal Treatment Study of Children With ADHD, which was initially a 14-month randomized controlled trial that compared medication management, behavior modification, a combination of both, or treatment as usual for a community comparison in 579 children with ADHD aged 7.0 to 9.9 years.
The trial was then transitioned into a long-term observational study in which 515 original study participants took part, as well as 289 individuals from the same schools, who were recruited to act as a local normal comparison group. Of these control participants, 258 did not have ADHD.
The participants were assessed eight times 2 to 16 years after baseline. The number of days on which patients were treated with stimulant medication and the daily doses that were administered since the previous assessment were recorded.
Using preestablished cutoffs for medication use, participants were classified as consistent, inconsistent, or negligible users. After they had reached adulthood, the participants completed the Conners Adult ADHD Rating Scale to determine symptom persistence.
Follow-up data in adulthood were available for 92.4% of the ADHD group and for 93.4% of the non-ADHD comparison group who started the observational phase. The majority of adult assessments were from the 16-year follow-up.
During follow-up, there was a fourfold decrease in the overall percentage of ADHD patients who were classified as having greater than minimal use of medication use; 23.5% were classified as having a negligible pattern of medication use; 61.9% as having an inconsistent pattern; and 7.4% as having a consistent pattern.