ABSTRACT
INTRODUCTION: Lisdexanfetamine (LDX) is the drug for attention deficit hyperactivity disorder (ADHD) undergoing the largest research volume in the latest years. However, no studies certify its usefulness for the improvement of cognitive functioning in ADHD. AIM: To evaluate the efficacy of LDX in the behavioral and cognitive improvement of a group of patients with ADHD. Such efficacy was measured by means of the administration of AULA Nesplora virtual reality test before the prescription of pharmacological treatment and right after the treatment with LDX. PATIENTS AND METHODS: The sample comprised 85 patients between 6 and 16 years, with clinical diagnosis of ADHD, who attended treatment in a neuropediatrics consultation. All patients started pharmacological treatment with the proper dose of LDX after the clinical interview and the first administration of AULA test. After an average treatment of 7.5 months, AULA was administered again and the treatment progress based on cognitive and motor symptomatology was assessed. RESULTS: Results showed highly significant improvements in selective and sustained attention, quality of attention focus and hyperactivity; moderate improvements in impulsivity; and an incidence close to zero in processing speed. CONCLUSIONS: LDX constitutes an adequate treatment for the substantial improvement of attention and hyperactivity; such improvement can be monitored accurately by means of AULA virtual reality test.
TITLE: Eficacia de la lisdexanfetamina en la mejora sintomatica conductual y cognitiva del trastorno por deficit de atencion/ hiperactividad: tratamiento monitorizado mediante el test AULA Nesplora de realidad virtual.Introduccion. La lisdexanfetamina (LDX) es el farmaco para el trastorno por deficit de atencion/hiperactividad (TDAH) con mayor volumen de investigacion de los ultimos años. No obstante, no hay estudios que certifiquen su utilidad para la mejoria del funcionamiento cognitivo en el TDAH. Objetivo. Evaluar la eficacia de la LDX en la mejora sintomatica conductual y cognitiva en un grupo de pacientes con TDAH. Dicha eficacia fue medida mediante la administracion del test AULA Nesplora de realidad virtual antes de la prescripcion del tratamiento farmacologico y despues del tratamiento con LDX. Pacientes y metodos. La muestra estaba compuesta por 85 pacientes de 6-16 años, con diagnostico clinico de TDAH y que asistian a tratamiento en una consulta de neuropediatria. Todos los pacientes iniciaron el tratamiento farmacologico con la correspondiente dosis de LDX tras la entrevista clinica y la primera administracion del test AULA. Tras un tratamiento medio de 7,5 meses, se les administro AULA nuevamente y se valoro el progreso del tratamiento farmacologico sobre la sintomatologia cognitiva y motora. Resultados. Se apreciaron mejorias muy significativas en la atencion selectiva y sostenida, la calidad del foco atencional y la hiperactividad, mejorias moderadas en la impulsividad, y una incidencia casi nula en la velocidad de procesamiento. Conclusiones. La LDX constituye un tratamiento adecuado para la mejora sustancial de la atencion e hiperactividad, y dicha mejora puede monitorizarse de forma precisa mediante el test de realidad virtual AULA.
Subject(s)
Attention Deficit Disorder with Hyperactivity/drug therapy , Cognition , Lisdexamfetamine Dimesylate/therapeutic use , Adolescent , Attention , Central Nervous System Stimulants , Child , Disruptive, Impulse Control, and Conduct Disorders/drug therapy , Humans , Treatment OutcomeABSTRACT
RESUMEN. Objetivo. Analizar el coste-efectividad y la aceptación de tres tratamientos psicológicos (cony sin parches de nicotina), aplicados en un contexto de Atención Primaria.Material y métodos. Participaron 164 fumadores que fueron distribuidos al azar a tres condiciones de tratamiento: consejo breve, autoayuda más seguimiento telefónico y tratamiento psicológico intensivo. Además, dentro de cada condición, los participantes se distribuyeron en dos subgrupos:tratamiento psicológico solo frente a tratamiento psicológico más parches de nicotina.Resultados. De las 6 condiciones de tratamiento,los tratamientos que no emplearon parches de nicotina fueron más eficientes. El tratamiento más intensivo fue el que consiguió el mayor gradode adhesión. El 75% de los pacientes de este grupo acudieron a todas las sesiones y el 68% completaron las 8 semanas de parches de nicotina. Conclusiones. Los tratamientos conductuales sonaltamente coste-efectivos cuando se aplican en los centros de salud. Estos resultados apoyan la factibilidadde integrar las orientaciones clínica y de salud pública en un único entorno, facilitando la accesibilidad accesibilidadde tratamientos eficaces a poblaciones ampliasde fumadores (AU)
ABSTRACT. Objective. To analyze the cost-effectiveness and acceptability of three psychological treatments (with and without nicotine patches), appliedin the Primary Care context. Material and methods. Participants were 164 smokers randomly distributed to three treatment conditions: brief advice, self-help plus telephone followup, and intensive psychological treatment. Moreover,within each condition, participants were distributed in two sub-groups: psychological treatment only versus psychological treatment plus nicotine patches. Results. Of the six treatment conditions, those without the use of nicotine patches were more efficient.The most intensive treatment was that which achieved the highest level of adherence. A total of75% of the patients from this group attended all thesessions, and 68% completed the eight weeks of nicotine patches.Conclusions. Behavioural treatments are highy cost-effective when applied in Primary Care. Theseresults support the viability of combining clinicaland public health approaches in a single context,thus facilitating accessibility to effective treatment for large populations of smokers (AU)
Subject(s)
Male , Female , Adult , Middle Aged , Aged , Humans , Tobacco Use Disorder/psychology , Tobacco Use Disorder/therapy , Psychotherapy , Directive Counseling , Cost Efficiency Analysis , Treatment Outcome , Follow-Up StudiesABSTRACT
Medical knowledge that can be used in everyday life is easily learned; therefore, the educational activities about care of pregnancy, puerperium and the newborn are important. In a study about appropriate technologies in obstetrics it was investigated to what extent the surveyed women had followed psychoprophylactic courses and had received information at the time of discharge after admission for delivery. Only 47% had followed a psychoprophylactic course and 54-71% had received information before discharge; the rates were smaller in those women receiving attention at public institutions. This group started the surveillance of pregnancy later (27% after the fourth month); it was also in this group where the least proportion of women always cared for by the same physician during pregnancy (60%) and delivery (26%) was found. It was this group, therefore, that had the least opportunity to create an adequate relation with the physician and to receive educational care. This is a matter for consideration about the modalities of attention and underlying purposes of educational activities, which seem to be directed in a greater proportion to the groups with higher socioeconomic status.
