RCGP challenges ‘Shape of Training’ report over GP training time

RCGP challenges ‘Shape of Training’ report over GP training time

August 17 2017 General practice training should be at least four years and not as proposed in the...

RCGP warns that workforce numbers are falling short of targets, one year in to GPFV

RCGP warns that workforce numbers are falling short of targets, one year in to GPFV

August 1 2017 NHS England’s plan to recruit an additional 5,000 GPs by 2020 is...

Study finds 7-day GP service decreases demand on A&E

Study finds 7-day GP service decreases demand on A&E

June 22 2016 Demand on accident and emergency departments has potentially reduced by almost a...

Experiences of four vanguard schemes shared in new publication

Experiences of four vanguard schemes shared in new publication

June 20 2016 Empowering staff to lead services changes helps individuals and communities make...

Scotland workforce survey indicates 2% decline in GPs

Scotland workforce survey indicates 2% decline in GPs

June 15 2016 The whole time equivalent (WTE) number of GPs working in practices declined 2%...

  • RCGP challenges ‘Shape of Training’ report over GP training time

    RCGP challenges ‘Shape of Training’ report over GP training time

    Thursday, 17 August 2017 19:38
  • RCGP warns that workforce numbers are falling short of targets, one year in to GPFV

    RCGP warns that workforce numbers are falling short of targets, one year in to GPFV

    Saturday, 05 August 2017 13:57
  • Study finds 7-day GP service decreases demand on A&E

    Study finds 7-day GP service decreases demand on A&E

    Wednesday, 22 June 2016 10:54
  • Experiences of four vanguard schemes shared in new publication

    Experiences of four vanguard schemes shared in new publication

    Tuesday, 21 June 2016 10:41
  • Scotland workforce survey indicates 2% decline in GPs

    Scotland workforce survey indicates 2% decline in GPs

    Wednesday, 15 June 2016 11:21

adhdDecember 2 2015

Researchers have urged doctors to be cautious if considering prescribing methylphenidate for children or adolescents with attention deficit hyperactivity disorder (ADHD).

A Cochrane review has concluded that the drug may improve teacher-reported ADHD symptoms, teacher-reported general behaviour, and parent-reported quality of life among children and adolescents diagnosed with ADHD. “However, the low quality of the underpinning evidence means that we cannot be certain of the magnitude of the effects.”

The researchers assessed 38 parallel-group trials and 147 cross-over trials, representing over 12,200 patients, and found methylphenidate led to “modest” improvements in ADHD symptoms as a primary outcome. They also found there were improvements in general behaviour and quality of life. However, in all outcomes, the quality of the evidence was judged to be “very low”.

Data for serious adverse events was only reported in nine out of the 185 trials, meaning that while methylphenidate does not appear to be associated with an increased risk of serious adverse events, the quality of the evidence was again very low.

“It was apparent from assessing the included trials that it would have been possible for people involved in the trials to have been aware of which treatment the children were taking,” says Cochrane. “In addition, the reporting of results was not complete in many of the trials, and for some analyses there was variation among trial results.

“Based upon this information, the researchers urge clinicians to be cautious in prescribing methylphenidate, and to weigh up the benefits and risks more carefully.”

Professor Ole Jakob Storebø, a clinical psychologist from the Psychiatric Research Unit in Region Zealand, Denmark, led the team of 18 researchers carrying out the meta-analysis. “This review highlights the need for long-term, large, better-quality randomized trials so that we can determine the average effect of this drug more reliably,” he said.

Co-author Camilla Groth MD added: “This review shows very limited quality evidence for the effects of methylphenidate on children and adolescents with ADHD. Some might benefit, but we still don’t know which patients will do so. Clinicians prescribing methylphenidate must take account of the poor quality of the evidence, monitor treatment carefully, and weigh up the benefits and adverse effects.”

Links:

Cochrane announcement

Cochrane review summary

Ole Jakob Storebø et al. ‘Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD)’. Cochrane Library. Published online November 25 2015.

Management News

August 18 2017 GPs lack familiarity with current physical activity guidelines, a survey has found. Only 20% of the 1,013 GPs in England responding to the survey “were broadly or very familiar with the...
December 10 2015 A doctor may find themselves the subject of an investigation at any time in their career, from medical students to trainee doctors, GPs or consultants. Whether it’s an issue...