Search

Background: Burden on caregivers of children/adolescents with attention-deficit/hyperactivity disorder (ADHD) is multidimensional, but incompletely understood. Objective: To analyze caregiver burden across the concepts of work, social/family life, and parental worry/stress, in relation to selected contributing factors. Methods: The online Caregiver Perspective on Pediatric ADHD survey was fielded in ten European countries. Analysis included children/adolescents (6-17 years) who were receiving/had received ADHD pharmacotherapy in the previous 6 months. Caregivers recorded their child's/adolescent's symptoms "on"/"off" medication (ie, when the caregiver reported that the child/adolescent forgot/chose not to take medication, before the onset of medication effect, or medication worn off). Effects of ADHD severity, comorbidities, and medication adherence on each burden outcome were assessed (multiple regression models). Results: In total, 2,326 caregivers were included (children/adolescents' mean age: 11.5 years, 80% male). Caregivers reported missed/altered work, avoiding social activity, increased parental worry/stress, and strain on family life, despite using ADHD pharmacotherapy. Child/adolescent comorbidities and ADHD severity were significantly related to all burden concepts measured; the strongest comorbidity associations were with altered work (odds ratios [ORs] =1.68 [95% confidence interval {CI} 1.33, 2.12], 1.87 [1.37, 2.54], 3.47 [2.51, 4.78] for 1, 2, 3+ comorbidities, respectively) and planning the day around the child/adolescent (OR =1.42 [95% CI 1.17, 1.72], 1.73 [1.33, 2.15], 2.65 [1.99, 3.53]); the strongest severity associations were: quitting a job (OR =1.41 [95% CI 1.26, 1.59]) and planning a day around the child/adolescent (OR =1.26 [95% CI 1.20, 1.32]). Increased medication adherence was most associated with reducing the caregiver burden for altered work (OR =0.57 [95% CI 0.45, 0.72]), worrying about how they are being perceived as a parent (OR =0.68 [0.56, 0.83]), and avoiding social activity (OR =0.56 [0.45, 0.68]), but not family or stress burden. Conclusion: Burdens related to work, social activity, family life, and parental worry/stress were experienced by the caregivers of children/adolescents with ADHD, despite using ADHD pharmacotherapy. Better understanding of clinical/treatment characteristics most associated with the components of caregiver burden may help improve ADHD management and may ease caregiver burden. [ABSTRACT FROM AUTHOR]

Background: With preliminary data suggesting an increasing trend in attention-deficit/hyperactivity disorder (ADHD) prevalence in Europe, the use of psychotropic medications in this population needs to be better understood, particularly among patients with ADHD and no co-morbid psychiatric disorder. Methods: Medical charts of patients aged 6–17 years with one or more ADHD diagnosis between January 1, 2004 and June 30, 2007, and use of ADHD medication were abstracted by physicians from six European countries. Patients with a history of epilepsy or diagnosis of Tourette syndrome were excluded. Results: Among a convenience sample of 569 children/adolescent patients (mean age, 12.1 years), 80 (14.1 %) patients used psychotropic concomitant medication (PCM) along with their current on-label ADHD medication. The number of pre-existing co-morbidities, high impairment due to the symptom of anger, and country (France; Italy; the Netherlands; and Spain vs. the reference country, Germany) were significantly associated with PCM use (UK was not significantly different vs. Germany). In particular, in France, Italy, the Netherlands, and Spain, PCM use was highest. Conclusions: These findings suggest that greater attention to the use of PCM, which are not indicated for the treatment of ADHD, may be warranted in children and adolescents receiving PCM. This highlights the need for further research to assess the impact of PCM use in ADHD patients and to consider alternative, individualized, indicated treatment strategies for patients with ADHD. [ABSTRACT FROM AUTHOR]

This study investigated the incidence of anemia in chemotherapy-treated intermediate-grade nonHodgkin's lymphoma (IGNHL) patients. A historic case series design was used. The study data were obtained from 12 oncology practices that participated in the Oncology Practice Pattern Study (OPPS). The analysis focused on 353 IGNHL patients with normal baseline (prechemotherapy) hemoglobin (Hb) (≥ 12.0 g/dL). These patients were treated with CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone combination) therapy (at some point) from 1993 through 1999. Anemia was found to be prominent during chemotherapy. About 24% of the patients with a normal baseline Hb level dropped below 10.0 g/dL and 49% dropped to 10.0 -11.9 g/dL, at some point during chemotherapy. As anemia treatment data were unavailable, it is likely that some of these patients received therapy to boost their Hb levels, rendering our results conservative. A logistic regression model revealed that in patients with normal baseline Hb, age ≥ 60, female gender, lower baseline Hb level, and lymphoma histology classified as the Working Formulation (WF) E or H were significant predictors of a drop in Hb below 10.0 g/dL during chemotherapy. Chemotherapy-induced anemia is frequently observed in lymphoma patients. It is possible to identify adverse baseline patient characteristics associated with higher risk of chemotherapy-induced anemia and carefully monitor such patients. Additional studies in community oncology practice are warranted to validate these findings and improve our understanding of the problems of anemia in chemotherapy treated non-Hodgkin's lymphoma (NHL) patients. J Oncol Pharm Practice (2002) 8, 73-80. [ABSTRACT FROM AUTHOR]

Examines the incidence of anemia among women treated with doxorubicin and cyclophosphamide chemotherapy for early stage of breast cancer. Importance of monitoring the hemoglobin levels of women; Factors contributing ot the severity of anemia; Myelosuppressive characteristics of chemotherapy regimen.

Conclusions. Our study results support previous findings of a high prevalence of anemia in cancer patients before cytotoxic therapy and the adverse impact that baseline anemia has on response to chemotherapy. [ABSTRACT FROM AUTHOR]