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Conference Paper: Attention-deficit/Hyperactivity Disorder (ADHD) pharmacological treatment and its effect on accident and emergency admission due to injury: a self-controlled case-series study

TitleAttention-deficit/Hyperactivity Disorder (ADHD) pharmacological treatment and its effect on accident and emergency admission due to injury: a self-controlled case-series study
Authors
KeywordsPharmacy and pharmacology
Issue Date2014
PublisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/5669
Citation
The 30th International Conference on Pharmacoepidemiology & Therapeutic Risk Management, Taipei, Taiwan, 24-27 October 2014. In Pharmacoepidemiology and Drug Safety, 2014, v. 23 S1, p. 317, abstract no. 597 How to Cite?
AbstractBACKGROUND: Attention-Deficit/Hyperactivity Disorder (ADHD) patients have a higher tendency to sustain trauma requiring Accident & Emergency Department (ED) visits. Evidence that ADHD patients on pharmacotherapy tend to have a lower ED admission rate compared to those without medication is limited. OBJECTIVES: To investigate the association between ADHD drug treatment and Accident & Emergency Department (ED) admission from injuries. METHODS: Design: Self-controlled case series study. SETTING: Patients aged 6 to 19 with at least one prescription of Methylphenidate (MPH) and at least one ED admission from injury in 2001 to 2013 were identified (n = 5178) using Hong Kong Population-based electronic medical records in the Clinical Data Analysis & Reporting System (CDARS). Main Outcome Measure: Relative incidence of ED admission from injuries comparing exposed and non-exposed periods was estimated. Individual observation period commenced latest 1st January, 2001 or on patient’s 6th birthday, and ended earliest 31st December, 2013, on the patient’s 20th birthday or the date of registered death. The Incidence Rate Ratios (IRRs) and the corresponding 95% confidence intervals were calculated using conditional Poisson regression. RESULTS: Among patients prescribed MPH, the rate of ED admission from injuries was decreased during exposed periods compared to non-exposed periods (IRR = 0.91, 95%CI 0.86 to 0.97). Similar results were observed if only the first injury episode was counted (IRR = 0.88, 95%CI 0.81 to 0.96). Sensitivity Analysis was conducted by adding 1 to 10 weeks after the end of an exposed period which gave consistent results. CONCLUSIONS: This study supports the hypothesis that MPH can reduce the risk of injury-related ED admission in children and adolescents. Long term MPH treatment prevents injuries in this group of high-risk patients and this potential benefit should be considered in clinical practice.
DescriptionThis journal suppl. entitled: Special Issue: Abstracts of the 30th International Conference on Pharmacoepidemiology and Therapeutic Risk Management ... 2014
Persistent Identifierhttp://hdl.handle.net/10722/206040
ISSN
2015 Impact Factor: 2.908
2015 SCImago Journal Rankings: 1.804

 

DC FieldValueLanguage
dc.contributor.authorMan, KKCen_US
dc.contributor.authorChan, EWen_US
dc.contributor.authorDouglas, Ien_US
dc.contributor.authorIp, Pen_US
dc.contributor.authorWong, WHSen_US
dc.contributor.authorCoghill, Den_US
dc.contributor.authorWong, ICKen_US
dc.date.accessioned2014-10-20T11:47:20Z-
dc.date.available2014-10-20T11:47:20Z-
dc.date.issued2014en_US
dc.identifier.citationThe 30th International Conference on Pharmacoepidemiology & Therapeutic Risk Management, Taipei, Taiwan, 24-27 October 2014. In Pharmacoepidemiology and Drug Safety, 2014, v. 23 S1, p. 317, abstract no. 597en_US
dc.identifier.issn1053-8569-
dc.identifier.urihttp://hdl.handle.net/10722/206040-
dc.descriptionThis journal suppl. entitled: Special Issue: Abstracts of the 30th International Conference on Pharmacoepidemiology and Therapeutic Risk Management ... 2014-
dc.description.abstractBACKGROUND: Attention-Deficit/Hyperactivity Disorder (ADHD) patients have a higher tendency to sustain trauma requiring Accident & Emergency Department (ED) visits. Evidence that ADHD patients on pharmacotherapy tend to have a lower ED admission rate compared to those without medication is limited. OBJECTIVES: To investigate the association between ADHD drug treatment and Accident & Emergency Department (ED) admission from injuries. METHODS: Design: Self-controlled case series study. SETTING: Patients aged 6 to 19 with at least one prescription of Methylphenidate (MPH) and at least one ED admission from injury in 2001 to 2013 were identified (n = 5178) using Hong Kong Population-based electronic medical records in the Clinical Data Analysis & Reporting System (CDARS). Main Outcome Measure: Relative incidence of ED admission from injuries comparing exposed and non-exposed periods was estimated. Individual observation period commenced latest 1st January, 2001 or on patient’s 6th birthday, and ended earliest 31st December, 2013, on the patient’s 20th birthday or the date of registered death. The Incidence Rate Ratios (IRRs) and the corresponding 95% confidence intervals were calculated using conditional Poisson regression. RESULTS: Among patients prescribed MPH, the rate of ED admission from injuries was decreased during exposed periods compared to non-exposed periods (IRR = 0.91, 95%CI 0.86 to 0.97). Similar results were observed if only the first injury episode was counted (IRR = 0.88, 95%CI 0.81 to 0.96). Sensitivity Analysis was conducted by adding 1 to 10 weeks after the end of an exposed period which gave consistent results. CONCLUSIONS: This study supports the hypothesis that MPH can reduce the risk of injury-related ED admission in children and adolescents. Long term MPH treatment prevents injuries in this group of high-risk patients and this potential benefit should be considered in clinical practice.-
dc.languageengen_US
dc.publisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/5669-
dc.relation.ispartofPharmacoepidemiology and Drug Safetyen_US
dc.rightsPharmacoepidemiology and Drug Safety. Copyright © John Wiley & Sons Ltd.-
dc.subjectPharmacy and pharmacology-
dc.titleAttention-deficit/Hyperactivity Disorder (ADHD) pharmacological treatment and its effect on accident and emergency admission due to injury: a self-controlled case-series studyen_US
dc.typeConference_Paperen_US
dc.identifier.emailMan, KKC: mkckth@hku.hken_US
dc.identifier.emailChan, EW: ewchan@hku.hken_US
dc.identifier.emailIp, P: patricip@hku.hken_US
dc.identifier.emailWong, WHS: whswong@hku.hken_US
dc.identifier.emailWong, ICK: wongick@hku.hken_US
dc.identifier.authorityChan, EW=rp01587en_US
dc.identifier.authorityIp, P=rp01337en_US
dc.identifier.authorityWong, ICK=rp01480en_US
dc.identifier.doi10.1002/pds.3701-
dc.identifier.hkuros241303en_US
dc.identifier.volume23-
dc.identifier.issueS1-
dc.identifier.spage317, abstract no. 597-
dc.identifier.epage317, abstract no. 597-
dc.publisher.placeUnited Kingdom-
dc.customcontrol.immutablesml 141110-

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