Government submits its evidence for doctor remuneration

Government submits its evidence for doctor remuneration

January 31 2018 The Department of Health has published the written evidence it has submitted to...

Winter pressures prompts relaxation of QOF requirements in Wales

Winter pressures prompts relaxation of QOF requirements in Wales

January 9 2018 GPs in Wales will be able forego the Quality and Outcomes Framework (QOF) element...

ABPI responds to BMJ article on CCGs not declaring all funding from private organisations

ABPI responds to BMJ article on CCGs not declaring all funding from private organisations

January 8 2018 The BMJ has been criticised for the tone taken in its article highlighting how...

CCGs failed to disclose £3.7m in payments and gifts from private companies

CCGs failed to disclose £3.7m in payments and gifts from private companies

January 4 2018 Clinical commissioning groups failed to declare three quarters of the value of...

  • Government submits its evidence for doctor remuneration

    Government submits its evidence for doctor remuneration

    Wednesday, 31 January 2018 10:38
  • Winter pressures prompts relaxation of QOF requirements in Wales

    Winter pressures prompts relaxation of QOF requirements in Wales

    Tuesday, 09 January 2018 11:53
  • ABPI responds to BMJ article on CCGs not declaring all funding from private organisations

    ABPI responds to BMJ article on CCGs not declaring all funding from private organisations

    Monday, 08 January 2018 14:22
  • CCGs failed to disclose £3.7m in payments and gifts from private companies

    CCGs failed to disclose £3.7m in payments and gifts from private companies

    Thursday, 04 January 2018 12:14

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

February 21 2018 Public Health Wales has published further information about the tendering process for GP software which has seen EMIS Health not able to continue as a supplier.
February 20 2018 New British Thoracic Society guidelines on pleural mesothelioma include some key recommendations for primary care. The BTS guideline give recommendations and good practice points...