PATIENCE Individual Patient DATa Network Meta-AnalysIs of the Efficacy aNd aCceptability of Attention-Deficit/Hyperactivity Disorder (ADHD) mEdication

Attention-Deficit/Hyperactivity Disorder (ADHD) is the most common neurodevelopmental disorder and one of the most common diagnoses in child and adolescent mental health services. It has been estimated that the worldwide prevalence of ADHD is in the order of 5-7% in children [2] and 2.5% in adults [3]. ADHD is a heterogeneous disorder, primarily characterised by developmentally inappropriate inattention and/or hyperactivity-impulsivity to a degree that adversely affects schooling, work, and/or relationships. The disorder usually becomes apparent in early childhood [1] and, for approximately 70% of people, impairing symptoms continue into adulthood [4], disrupting the lives of patients and those around them.

For ADHD, as for many other disorders, clinicians, patients and parents/carers are faced with a range of possible medications to choose from. In the absence of evidence-based biomarkers and clinical predictors of response or adverse effects, currently treatment selection in the clinical practice often relies on trial-and-error.

Individual Patient Data Network Meta-Analyses (IPD-NMAs) analyse patient-level rather that group-level data. This type of analysis also has the capacity to provide estimates of the effects of medication on subgroups of patients with specific characteristics, such as previous exposure to medications, severity of symptoms and comorbidities which could moderate the effects of medications.

An IPD-NMA can help to inform guidelines, which in turn will have an impact on the treatment of ADHD, by enabling clinicians, patients and parents/carers to take patients’ personal characteristics into account when selecting medications. The results will inform clinical treatment guidelines on the management of ADHD.