Hayes Evaluates Test And Treatment Options For Attention-Deficit Hyperactivity Disorder
Main Category: ADHDArticle Date: 24 Aug 2008 - 1:00 PDT
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Hayes, Inc., an industry leader in providing independent, unbiased analyses of healthcare technologies, today announced that it has completed an exhaustive study of a wide range of medications to treat attention-deficit hyperactivity disorder (ADHD). The study was undertaken in response to significant customer interest in gaining a better understanding of those treatments that really work to relieve symptoms in ADHD sufferers.
ADHD is a common disorder of childhood and adolescence that may persist into adulthood and is characterized by symptoms of inattention and/or hyperactivity/impulsivity with symptoms lasting for at least 6 months and to an extent that is inconsistent with development level. It is estimated that up to 5% of the world's population suffers from ADHD.
Over the past three months, Hayes medical research analysts have reviewed the clinical evidence regarding a range of ADHD treatments for adults and children, including the use of stimulants, antidepressants, antihypertensives, and atomoxetine, a nonstimulant drug approved for treatment of ADHD. The results are not promising. Of the treatments evaluated, only one type of drug, stimulants, was given an "A" Hayes Rating for use in children and a "B" Rating for use in adults. One other drug, atomoxetine, was given a "B" Rating for use in children.
The Hayes Rating is a proprietary rating system with each rating reflecting the strength and direction of the evidence regarding the safety and efficacy of a medical technology (procedure, test, device, biologic, or drug), its impact on health outcomes, indications for use, patient selection criteria, and comparison with other technologies. Ratings are scaled A, established benefit, through D, no proven benefit and/or not safe.
Elisabeth Houtsmuller, PhD, Medical Research Analyst for Hayes, Inc., directed the evidence analysis for the ADHD project, and notes that "Healthcare payers and providers are grappling with the best techniques for treating ADHD as knowledge of this disruptive and sometimes debilitating disease spreads. Unfortunately, in most cases, current evidence is limited and further studies are needed before these drugs can be unequivocally recommended for use."
In addition, Hayes reviewed the effectiveness of neuropsychological testing for diagnosis of ADHD, finding that these tests do not have strong predictive value for ADHD diagnosis. Accordingly, neuropsychological testing was rated "D" for ADHD.
Houtsmuller added, "Unfortunately for sufferers of ADHD and their families, there are few clear conclusions that can be drawn from the research to date on the best treatment options. In the case of stimulant treatment for children, clinical studies do demonstrate short-term relief, but many families have concerns about administering stimulants to children. In these cases, atomoxetine represents a good option, with clinical evidence demonstrating some effectiveness."
Hayes conducts its research by thoroughly analyzing all peer-reviewed clinical studies and determining if studies were designed appropriately, if enough patients were involved, and if the studies answered critical questions about whether the treatments work or improve patient care.
About Hayes, Inc.
Hayes, Inc. provides unbiased, evidence-based research and analysis to help insurers, hospitals, and policy makers make informed healthcare decisions. The company's conclusions are independent, impartial, and objective, formulated by an international staff of medical research analysts drawn from a range of healthcare disciplines.
Hayes research and consulting services are used by a number of the world's leading healthcare organizations. More than 65% of U.S. healthcare insurers, serving approximately 150 million lives, depend on Hayes research when developing coverage policies. In addition, Hayes research supports hospitals as they make health technology acquisition decisions and is also provided by employers to help employees make better-informed healthcare choices.
Hayes, Inc. was founded by Winifred S. Hayes, PhD, in 1989, and is headquartered in suburban Philadelphia.
Hayes, Inc.
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ADHD Article, Comments From Atlanta
posted by Carol NCC on 25 Aug 2008 at 8:08 amWhen I saw this topic in an e-mail, I was very interested.
Unfortunately, my impression from reading this article is that your organization may exist as much to provide insurance companies with a way to deny coverage as it does to provide helpful information. I wonder who is funding your research!
The article includes such a high percentage of information about your organization that it sounds more like a sales pitch to get insurance companies and large providers interested.
In contrast, there is not enough information about the various AD/HD treatments you considered in your study. Although I generally agree with your conclusions about stimulant medication, I would like to have seen a bullet point list of every medication/treatment method you ruled out as not proven to be effective for AD/HD.
Most importantly, there is a great deal about the brain that we don't know. A medication that doesn't work for most people with AD/HD might be the one that works best for a few people. As a result of your study, insurance companies might deny coverage for a medication that makes it possible for some people to live a much better life.
If you are thinking that most insurance companies have an appeals process that would address this, please remember that people with functional problems (who are not taking the medication that helps them function best because the insurance company denied it) may have difficulty following through with an appeal. And those same people may not have an available, non-ADHD family member to help them fight for what they need.
Thank you.
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