This Mentored Patient-Oriented Research Career Development Award (K23) program is designed to develop expertise for becoming an independent investigator in the study of medication continuity in children with Attention-Deficit/Hyperactivity Disorder (ADHD) cared for in primary care settings. This is a critical area because despite the proven efficacy of stimulant medications to reduce ADHD symptoms, many children discontinue treatment, thereby preventing them from realizing the full therapeutic benefits of treatment and this contributes to unnecessary suffering for children and their families. The ultimate goal is to develop the expertise needed to develop evidence-based, personalized interventions to improve medication continuity among children and adolescents with ADHD. The Candidate's strong background of research and clinical training in pediatrics, education, and research provides an excellent foundation for this work. The proposed training goals include enhancing skills in the following areas: 1) biostatistical modeling with longitudinal data;2) adherence measurement;3) design and implementation of interventions for ADHD;4) development of psychological, adherence, and family/self management interventions;5) grant writing and presentation of scientific data. Achieving these training goals is essential to the Candidate's success in transitioning to independence as an investigator who pursues methodologically sound, technically feasible, and innovative approaches to intervention research in this population. The objective of the research plan is to better understand the factors that promote medication continuity in children with ADHD. A prospective, longitudinal cohort of 100 children 6-10 years old started on medicine for ADHD by their primary care doctor. The cohort will be recruited from 21 physicians in 7 practices. We will collect four waves of data over 18 months to address the following specific aims:
Aim 1 : Describe medication continuity in a community-based clinical cohort of children treated for ADHD.
Aim 2 : Identify reasons parents stop and re-start their child's medication treatment.
Aim 3 : Determine relationship between factors that influence family decision making and medication continuity. The Candidate plans to achieve his goal by translating knowledge gained from this study to 1) segment the population at risk for poor medication continuity and, 2) develop personalized interventions that target modifiable factors important to promote medication continuity.

Public Health Relevance

The proposed work is significant because ADHD results in impairment of academic, social, and family functioning. In addition, children with ADHD are at higher risk for injury, and as they reach adolescence are at higher risk for motor vehicle accidents, substance abuse, and risky sexual behavior. Poor medication continuity, therefore, contributes to unnecessary child, adolescent, and family suffering.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23MH083027-03
Application #
8197016
Study Section
Mental Health Services in Non-Specialty Settings (SRNS)
Program Officer
Hill, Lauren D
Project Start
2010-01-01
Project End
2014-11-30
Budget Start
2011-12-01
Budget End
2012-11-30
Support Year
3
Fiscal Year
2012
Total Cost
$176,491
Indirect Cost
$13,073
Name
Cincinnati Children's Hospital Medical Center
Department
Type
DUNS #
071284913
City
Cincinnati
State
OH
Country
United States
Zip Code
45229
Brinkman, William B; Epstein, Jeffery N; Auinger, Peggy et al. (2015) Association of attention-deficit/hyperactivity disorder and conduct disorder with early tobacco and alcohol use. Drug Alcohol Depend 147:183-9
Lipstein, Ellen A; Brinkman, William B; Fiks, Alexander G et al. (2015) An emerging field of research: challenges in pediatric decision making. Med Decis Making 35:403-8
Brady, Patrick W; Brinkman, William B; Simmons, Jeffrey M et al. (2014) Oral antibiotics at discharge for children with acute osteomyelitis: a rapid cycle improvement project. BMJ Qual Saf 23:499-507
Froehlich, Tanya E; Antonini, Tanya N; Brinkman, William B et al. (2014) Mediators of methylphenidate effects on math performance in children with attention-deficit hyperactivity disorder. J Dev Behav Pediatr 35:100-7
Chirdkiatgumchai, Vilawan; Xiao, Hong; Fredstrom, Bridget K et al. (2013) National trends in psychotropic medication use in young children: 1994-2009. Pediatrics 132:615-23
Lipstein, Ellen A; Brinkman, William B; Sage, Jessica et al. (2013) Understanding treatment decision making in juvenile idiopathic arthritis: a qualitative assessment. Pediatr Rheumatol Online J 11:34
Wyatt, Kirk D; Prutsky Lopez, Gabriela; Domecq Garces, Juan Pablo et al. (2013) Study protocol: a systematic review of pediatric shared decision making. Syst Rev 2:48
Parker, Michelle W; Schaffzin, Joshua K; Lo Vecchio, Andrea et al. (2013) Rapid adoption of Lactobacillus rhamnosus GG for acute gastroenteritis. Pediatrics 131 Suppl 1:S96-102
Jerardi, Karen E; Elkeeb, Dena; Weiser, Jason et al. (2013) Rapid implementation of evidence-based guidelines for imaging after first urinary tract infection. Pediatrics 132:e749-55
Brinkman, William B; Sherman, Susan N; Zmitrovich, April R et al. (2012) In their own words: adolescent views on ADHD and theirýýevolving role managing medication. Acad Pediatr 12:53-61

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