A pragmatic randomised controlled trial of the effectiveness and cost-effectiveness of Well Parent Japan in routine care in Japan: The training and nurturing support for mothers (TRANSFORM) study / Shizuka SHIMABUKURO in Journal of Child Psychology and Psychiatry, 65-12 (December 2024)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 65-12 (December 2024) . - p.1624-1637 Titre : A pragmatic randomised controlled trial of the effectiveness and cost-effectiveness of Well Parent Japan in routine care in Japan: The training and nurturing support for mothers (TRANSFORM) study Type de document : texte imprimé Auteurs : Shizuka SHIMABUKURO, Auteur ; Takashi OSHIO, Auteur ; Takahiro ENDO, Auteur ; Satoshi HARADA, Auteur ; Yushiro YAMASHITA, Auteur ; Akemi TOMODA, Auteur ; Boliang GUO, Auteur ; Yuko GOTO, Auteur ; Atsuko ISHII, Auteur ; Mio IZUMI, Auteur ; Yukiko NAKAHARA, Auteur ; Kazushi YAMAMOTO, Auteur ; David DALEY, Auteur ; Gail TRIPP, Auteur Article en page(s) : p.1624-1637 Langues : Anglais (eng) Mots-clés : ADHD  parent training  Japan  New Forest Parent Programme  Parent Stress Management Index. décimale : PER Périodiques Résumé : Background Well Parent Japan (WPJ) is a new hybrid group parent training programme combining sessions to improve mothers' psychological well-being with a culturally adapted version of the New Forest Parenting Programme (NFPP). This study investigates the effectiveness and cost-effectiveness of WPJ against treatment as usual (TAU) within Japanese child mental health services. Methods TRANSFORM was a pragmatic multi-site randomised controlled trial (RCT) with two parallel arms. Altogether 124 mothers of 6 12-year-old children with DSM-5 ADHD were randomised to WPJ (n 65) or TAU (n 59). Participants were assessed at baseline, post-treatment and three-month follow-up. The primary outcome was parent-domain stress following intervention. Secondary outcomes included maternal reports of child-domain stress, parenting practices, parenting efficacy, mood, family strain, child behaviour and impairment. Objective measures of the parent?child relationship were collected at baseline and post-treatment. Data analysis was intention to treat (ITT) with treatment effects quantified through analysis of covariance (ANCOVA) via multilevel modelling. An incremental cost-effectiveness ratio (ICER) assessed WPJ's cost-effectiveness. Results WPJ was superior to TAU in reducing parent-domain stress post-treatment (adjusted mean difference 5.05, 95% CI 0.33 to 9.81, p .036) and at follow-up (adjusted mean difference 4.82, 95% CI 0.09 to 9.55, p .046). Significant WPJ intervention effects were also observed for parenting practices, parenting efficacy and family strain. WPJ and TAU were not significantly different post-intervention or at follow-up for the other secondary outcomes. The incremental cost of WPJ was 34,202 JPY (315.81 USD). The probability that WPJ is cost-effective is 74% at 10,000 JPY (USD 108.30) per one-point improvement in parenting stress, 92% at 20,000 JPY (216.60 USD). The programme was delivered with high fidelity and excellent retention. Conclusions WPJ can be delivered in routine clinical care at modest cost with positive effects on self-reported well-being of the mothers, parenting practices and family coping. WPJ is a promising addition to psychosocial interventions for ADHD in Japan. En ligne : https://doi.org/10.1111/jcpp.14007 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=542 [article] A pragmatic randomised controlled trial of the effectiveness and cost-effectiveness of Well Parent Japan in routine care in Japan: The training and nurturing support for mothers (TRANSFORM) study [texte imprimé] / Shizuka SHIMABUKURO, Auteur ; Takashi OSHIO, Auteur ; Takahiro ENDO, Auteur ; Satoshi HARADA, Auteur ; Yushiro YAMASHITA, Auteur ; Akemi TOMODA, Auteur ; Boliang GUO, Auteur ; Yuko GOTO, Auteur ; Atsuko ISHII, Auteur ; Mio IZUMI, Auteur ; Yukiko NAKAHARA, Auteur ; Kazushi YAMAMOTO, Auteur ; David DALEY, Auteur ; Gail TRIPP, Auteur . - p.1624-1637. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 65-12 (December 2024) . - p.1624-1637 Mots-clés : ADHD  parent training  Japan  New Forest Parent Programme  Parent Stress Management Index. décimale : PER Périodiques Résumé : Background Well Parent Japan (WPJ) is a new hybrid group parent training programme combining sessions to improve mothers' psychological well-being with a culturally adapted version of the New Forest Parenting Programme (NFPP). This study investigates the effectiveness and cost-effectiveness of WPJ against treatment as usual (TAU) within Japanese child mental health services. Methods TRANSFORM was a pragmatic multi-site randomised controlled trial (RCT) with two parallel arms. Altogether 124 mothers of 6 12-year-old children with DSM-5 ADHD were randomised to WPJ (n 65) or TAU (n 59). Participants were assessed at baseline, post-treatment and three-month follow-up. The primary outcome was parent-domain stress following intervention. Secondary outcomes included maternal reports of child-domain stress, parenting practices, parenting efficacy, mood, family strain, child behaviour and impairment. Objective measures of the parent?child relationship were collected at baseline and post-treatment. Data analysis was intention to treat (ITT) with treatment effects quantified through analysis of covariance (ANCOVA) via multilevel modelling. An incremental cost-effectiveness ratio (ICER) assessed WPJ's cost-effectiveness. Results WPJ was superior to TAU in reducing parent-domain stress post-treatment (adjusted mean difference 5.05, 95% CI 0.33 to 9.81, p .036) and at follow-up (adjusted mean difference 4.82, 95% CI 0.09 to 9.55, p .046). Significant WPJ intervention effects were also observed for parenting practices, parenting efficacy and family strain. WPJ and TAU were not significantly different post-intervention or at follow-up for the other secondary outcomes. The incremental cost of WPJ was 34,202 JPY (315.81 USD). The probability that WPJ is cost-effective is 74% at 10,000 JPY (USD 108.30) per one-point improvement in parenting stress, 92% at 20,000 JPY (216.60 USD). The programme was delivered with high fidelity and excellent retention. Conclusions WPJ can be delivered in routine clinical care at modest cost with positive effects on self-reported well-being of the mothers, parenting practices and family coping. WPJ is a promising addition to psychosocial interventions for ADHD in Japan. En ligne : https://doi.org/10.1111/jcpp.14007 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=542

The impact of a computerised test of attention and activity (QbTest) on diagnostic decision-making in children and young people with suspected attention deficit hyperactivity disorder: single-blind randomised controlled trial / Chris HOLLIS in Journal of Child Psychology and Psychiatry, 59-12 (December 2018)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 59-12 (December 2018) . - p.1298-1308 Titre : The impact of a computerised test of attention and activity (QbTest) on diagnostic decision-making in children and young people with suspected attention deficit hyperactivity disorder: single-blind randomised controlled trial Type de document : texte imprimé Auteurs : Chris HOLLIS, Auteur ; Charlotte L. HALL, Auteur ; Boliang GUO, Auteur ; Marilyn JAMES, Auteur ; Janet BOADU, Auteur ; Madeleine J. GROOM, Auteur ; Nikki BROWN, Auteur ; Catherine KAYLOR-HUGHES, Auteur ; Maria MOLDAVSKY, Auteur ; Althea Z. VALENTINE, Auteur ; Gemma M. WALKER, Auteur ; David DALEY, Auteur ; Kapil SAYAL, Auteur ; Richard MORRISS, Auteur Article en page(s) : p.1298-1308 Langues : Anglais (eng) Mots-clés : QbTest  assessment  attention deficit hyperactivity disorder  continuous performance test Index. décimale : PER Périodiques Résumé : BACKGROUND: Diagnosis of attention deficit hyperactivity disorder (ADHD) relies on subjective methods which can lead to diagnostic uncertainty and delay. This trial evaluated the impact of providing a computerised test of attention and activity (QbTest) report on the speed and accuracy of diagnostic decision-making in children with suspected ADHD. METHODS: Randomised, parallel, single-blind controlled trial in mental health and community paediatric clinics in England. Participants were 6-17 years-old and referred for ADHD diagnostic assessment; all underwent assessment-as-usual, plus QbTest. Participants and their clinician were randomised to either receive the QbTest report immediately (QbOpen group) or the report was withheld (QbBlind group). The primary outcome was number of consultations until a diagnostic decision confirming/excluding ADHD within 6-months from baseline. Health economic cost-effectiveness and cost utility analysis was conducted. Assessing QbTest Utility in ADHD: A Randomised Controlled Trial was registered at ClinicalTrials.gov (https://clinicaltrials.gov/ct2/show/NCT02209116). RESULTS: One hundred and thirty-two participants were randomised to QbOpen group (123 analysed) and 135 to QbBlind group (127 analysed). Clinicians with access to the QbTest report (QbOpen) were more likely to reach a diagnostic decision about ADHD (hazard ratio 1.44, 95% CI 1.04-2.01). At 6-months, 76% of those with a QbTest report had received a diagnostic decision, compared with 50% without. QbTest reduced appointment length by 15% (time ratio 0.85, 95% CI 0.77-0.93), increased clinicians' confidence in their diagnostic decisions (odds ratio 1.77, 95% CI 1.09-2.89) and doubled the likelihood of excluding ADHD. There was no difference in diagnostic accuracy. Health economic analysis showed a position of strict dominance; however, cost savings were small suggesting that the impact of providing the QbTest report within this trial can best be viewed as 'cost neutral'. CONCLUSIONS: QbTest may increase the efficiency of ADHD assessment pathway allowing greater patient throughput with clinicians reaching diagnostic decisions faster without compromising diagnostic accuracy. En ligne : http://dx.doi.org/10.1111/jcpp.12921 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=371 [article] The impact of a computerised test of attention and activity (QbTest) on diagnostic decision-making in children and young people with suspected attention deficit hyperactivity disorder: single-blind randomised controlled trial [texte imprimé] / Chris HOLLIS, Auteur ; Charlotte L. HALL, Auteur ; Boliang GUO, Auteur ; Marilyn JAMES, Auteur ; Janet BOADU, Auteur ; Madeleine J. GROOM, Auteur ; Nikki BROWN, Auteur ; Catherine KAYLOR-HUGHES, Auteur ; Maria MOLDAVSKY, Auteur ; Althea Z. VALENTINE, Auteur ; Gemma M. WALKER, Auteur ; David DALEY, Auteur ; Kapil SAYAL, Auteur ; Richard MORRISS, Auteur . - p.1298-1308. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 59-12 (December 2018) . - p.1298-1308 Mots-clés : QbTest  assessment  attention deficit hyperactivity disorder  continuous performance test Index. décimale : PER Périodiques Résumé : BACKGROUND: Diagnosis of attention deficit hyperactivity disorder (ADHD) relies on subjective methods which can lead to diagnostic uncertainty and delay. This trial evaluated the impact of providing a computerised test of attention and activity (QbTest) report on the speed and accuracy of diagnostic decision-making in children with suspected ADHD. METHODS: Randomised, parallel, single-blind controlled trial in mental health and community paediatric clinics in England. Participants were 6-17 years-old and referred for ADHD diagnostic assessment; all underwent assessment-as-usual, plus QbTest. Participants and their clinician were randomised to either receive the QbTest report immediately (QbOpen group) or the report was withheld (QbBlind group). The primary outcome was number of consultations until a diagnostic decision confirming/excluding ADHD within 6-months from baseline. Health economic cost-effectiveness and cost utility analysis was conducted. Assessing QbTest Utility in ADHD: A Randomised Controlled Trial was registered at ClinicalTrials.gov (https://clinicaltrials.gov/ct2/show/NCT02209116). RESULTS: One hundred and thirty-two participants were randomised to QbOpen group (123 analysed) and 135 to QbBlind group (127 analysed). Clinicians with access to the QbTest report (QbOpen) were more likely to reach a diagnostic decision about ADHD (hazard ratio 1.44, 95% CI 1.04-2.01). At 6-months, 76% of those with a QbTest report had received a diagnostic decision, compared with 50% without. QbTest reduced appointment length by 15% (time ratio 0.85, 95% CI 0.77-0.93), increased clinicians' confidence in their diagnostic decisions (odds ratio 1.77, 95% CI 1.09-2.89) and doubled the likelihood of excluding ADHD. There was no difference in diagnostic accuracy. Health economic analysis showed a position of strict dominance; however, cost savings were small suggesting that the impact of providing the QbTest report within this trial can best be viewed as 'cost neutral'. CONCLUSIONS: QbTest may increase the efficiency of ADHD assessment pathway allowing greater patient throughput with clinicians reaching diagnostic decisions faster without compromising diagnostic accuracy. En ligne : http://dx.doi.org/10.1111/jcpp.12921 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=371

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