Center for Health Outcomes Research at UBC, 7101 Wisconsin Avenue, Suite 600 Bethesda, MD 20814, USA.
Expert Rev Pharmacoecon Outcomes Res. 2006 Aug;6(4):379-90. doi: 10.1586/14737167.6.4.379.
In children and adults, attention-deficit hyperactivity disorder is strongly associated with impairment in health-related quality of life as well as social, academic and occupational functioning. Thus, evaluation of treatment for attention-deficit hyperactivity disorder should assess the impact on functional status and health-related quality of life as well as potential symptom improvement. Atomoxetine is a relatively new nonstimulant medication indicated for the treatment of attention-deficit hyperactivity disorder in children and adults. The purpose of the current paper is to review studies examining the functional and health-related quality of life outcomes of atomoxetine treatment. Studies in this review included four types of measures: generic health-related quality of life instruments, condition-specific health-related quality of life instruments, functional status measures and utility-based assessments. A literature search identified 11 relevant outcome studies and two additional studies using a utility approach. Among children and adolescents, atomoxetine was associated with greater benefits than placebo on generic and condition-specific health-related quality of life measures (domains included children's behavior, mental health, self-esteem and parental impact) as well as measures of classroom behavior and evening behavior. Although findings from adult trials were not as consistent, initial results suggest that adults may also experience functional improvement (e.g., work, social and family functioning) associated with atomoxetine treatment. Overall, findings provide compelling support for the hypothesis that treatment of attention-deficit hyperactivity disorder can have broad positive effects beyond symptom improvement. Studies with active comparators are needed to determine whether the health-related quality of life benefits of atomoxetine are superior or comparable to those of stimulant medications.
在儿童和成人中，注意力缺陷多动障碍与健康相关生活质量以及社会、学业和职业功能受损密切相关。因此，评估注意力缺陷多动障碍的治疗效果应评估对功能状态和健康相关生活质量的影响，以及潜在的症状改善。托莫西汀是一种新型非兴奋剂药物，适用于治疗儿童和成人的注意力缺陷多动障碍。本文的目的是回顾评估托莫西汀治疗对功能和健康相关生活质量影响的研究。本综述中的研究包括四种类型的测量方法：一般健康相关生活质量量表、特定疾病健康相关生活质量量表、功能状态量表和基于效用的评估。文献检索确定了 11 项相关的结局研究和另外两项使用效用方法的研究。在儿童和青少年中，托莫西汀在一般和特定疾病健康相关生活质量测量（包括儿童行为、心理健康、自尊和父母影响等领域）以及课堂行为和晚间行为测量方面比安慰剂更有优势。尽管成人试验的结果并不一致，但初步结果表明，成人也可能因托莫西汀治疗而体验到功能改善（例如，工作、社会和家庭功能）。总的来说，这些发现有力地支持了这样一种假设，即治疗注意力缺陷多动障碍可以产生广泛的积极影响，不仅仅是症状改善。需要进行与活性对照药物的研究，以确定托莫西汀的健康相关生活质量益处是否优于或与兴奋剂药物相当。
