ADHD Treatment Change Impacts Remote Patient Monitoring

Personalized, daily self-reporting for patients could influence future therapeutic strategies.

A pilot study assessing the use of telemedicine in patient-reported responses to adult ADHD treatment showed a notable sensitivity to the impact of therapy changes on symptoms and patient functioning.

In new data presented at The American Professional Society of ADHD and Related Disorders (APSARD) 2021 Annual Conference, investigators from Massachusetts General Hospital reported outcomes from an online survey-based assessment of adults with ADHD asked to gauge real-time response to psychopharmacology.

They observed a likely correlation to patient sensitivity and mobile ADHD symptom monitoring following changes in treatment status.

The Shire and Takeda-supported trial, presented by author Craig Surman, MD, included 90-plus patients aged 18-80 who self-identified a taking stimulant therapy for ADHD. Participants recorded their demographic information, medication use history and patterns, and their symptoms associated with ADHD.

Surman and colleagues used mobile phone surveys and messaging systems from RedCAP to remotely monitor patients. Their hypothesis was that personalized surveys via mobile messaging could be sensitive to ADHD-specific therapy effects.

“Technology opens the possibility of using measurements by mobile messaging to inform clinical care,” they wrote. “We know that ADHD symptoms respond rapidly to some forms of psychopharmacology as measured on well-validated rating scales. In clinical practice, individuals may find particular symptoms easier to recognize and report on than others.”

Investigators used the Weiss Functional Impairment Rating Scale (WFIRS) and the Adult ADHD Self Report Scale v1.1 (ASRS) to gauge patient-reported therapy effects.

Participants identified medication-sensitive items, and received such items as queries during selected time periods in the morning and evening. From this, investigators inferred “on” and “off” medication statuses for analyses.

In their outcome, the research observed that data confirmed self-reported ADHD symptom severity discriminated “on” versus “off” stimulant therapy status.

Investigators also noted sensitivity thresholds for symptom reporting, as well as reporting patters: within-day and between-day differences.

“Mobile monitoring of ADHD symptoms and functional impact is likely sensitive to changes in treatment status,” they concluded. “Future research may validate the clinical utility of using personalized self-reported mobile-messaged items in treatment optimization.”

The study, “Sensitivity of Electronic Patient Reported Outcome Measures to Medication Effects in Adult ADHD – A Pilot Study,” was presented at APSARD 2021.