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Article: Methylphenidate and the Risk of Trauma

TitleMethylphenidate and the Risk of Trauma
Authors
Issue Date2015
Citation
Pediatrics, 2015, v. 135 n. 1, p. 40-48 How to Cite?
AbstractBACKGROUND AND OBJECTIVE: Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) are prone to sustaining trauma that requires emergency department (ED) admission. Methylphenidate (MPH) can reduce ADHD symptoms and may thus theoretically reduce the risk of trauma-related ED admission, but previous studies do not make this association clear. This study examines this association. METHODS: A total of 17 381 patients aged 6 to 19 years who received MPH prescriptions were identified by using the Clinical Data Analysis & Reporting System (2001–2013). Using a self-controlled case series study design, the relative incidence of trauma-related ED admissions was compared with periods of patient exposure and nonexposure to MPH. RESULTS: Among 17 381 patients prescribed MPH, 4934 had at least 1 trauma-related ED admission. The rate of trauma-related ED admission was lower during exposed periods compared with non-exposed periods (incidence rate ratio [IRR]: 0.91 [95% confidence interval (CI): 0.86–0.97]). The findings were similar only when the incident trauma episode was assessed (IRR: 0.89 [95% CI: 0.82–0.96]). A similar protective association was found in both genders. In validation analysis using nontrauma-related ED admissions as a negative control outcome, no statistically significant association was found (IRR: 0.99 [95% CI: 0.95–1.02]). All sensitivity analyses demonstrated consistent results. CONCLUSIONS: This study supports the hypothesis that MPH is associated with a reduced risk of trauma- related ED admission in children and adolescents. A similar protective association was found in both male and female patients. This protective association should be considered in clinical practice.
Persistent Identifierhttp://hdl.handle.net/10722/207251

 

DC FieldValueLanguage
dc.contributor.authorMan, KCKen_US
dc.contributor.authorChan, EWen_US
dc.contributor.authorCoghill, Den_US
dc.contributor.authorDouglas, Ien_US
dc.contributor.authorIp, Pen_US
dc.contributor.authorLeung, LPen_US
dc.contributor.authorTsui, MSHen_US
dc.contributor.authorWong, WHSen_US
dc.contributor.authorWong, ICKen_US
dc.date.accessioned2014-12-19T09:35:40Z-
dc.date.available2014-12-19T09:35:40Z-
dc.date.issued2015en_US
dc.identifier.citationPediatrics, 2015, v. 135 n. 1, p. 40-48en_US
dc.identifier.urihttp://hdl.handle.net/10722/207251-
dc.description.abstractBACKGROUND AND OBJECTIVE: Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) are prone to sustaining trauma that requires emergency department (ED) admission. Methylphenidate (MPH) can reduce ADHD symptoms and may thus theoretically reduce the risk of trauma-related ED admission, but previous studies do not make this association clear. This study examines this association. METHODS: A total of 17 381 patients aged 6 to 19 years who received MPH prescriptions were identified by using the Clinical Data Analysis & Reporting System (2001–2013). Using a self-controlled case series study design, the relative incidence of trauma-related ED admissions was compared with periods of patient exposure and nonexposure to MPH. RESULTS: Among 17 381 patients prescribed MPH, 4934 had at least 1 trauma-related ED admission. The rate of trauma-related ED admission was lower during exposed periods compared with non-exposed periods (incidence rate ratio [IRR]: 0.91 [95% confidence interval (CI): 0.86–0.97]). The findings were similar only when the incident trauma episode was assessed (IRR: 0.89 [95% CI: 0.82–0.96]). A similar protective association was found in both genders. In validation analysis using nontrauma-related ED admissions as a negative control outcome, no statistically significant association was found (IRR: 0.99 [95% CI: 0.95–1.02]). All sensitivity analyses demonstrated consistent results. CONCLUSIONS: This study supports the hypothesis that MPH is associated with a reduced risk of trauma- related ED admission in children and adolescents. A similar protective association was found in both male and female patients. This protective association should be considered in clinical practice.en_US
dc.languageengen_US
dc.relation.ispartofPediatricsen_US
dc.titleMethylphenidate and the Risk of Traumaen_US
dc.typeArticleen_US
dc.identifier.emailMan, KCK: mkckth@hku.hken_US
dc.identifier.emailChan, EW: ewchan@hku.hken_US
dc.identifier.emailIp, P: patricip@hku.hken_US
dc.identifier.emailTsui, MSH: mshtsui@hkucc.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.doi10.1542/peds.2014-1738en_US
dc.identifier.hkuros241950en_US

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