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    45.1 efficacy and cost-effectiveness of individual versus group-based parent training for preschool attention-deficit/hyperactivity disorder: A multi-center randomized controlled trial

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    Author
    Daley, David
    Keyword
    Costs and cost analysis
    Parents
    Attention deficit disorder with hyperactivity
    Date
    2016
    
    Metadata
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    DOI
    10.1016/j.jaac.2016.07.385
    Publisher's URL
    http://www.jaacap.com/article/S0890-8567(16)30734-1/fulltext
    Abstract
    Objectives: The goal of this presentation is to compare the efficacy and cost effectiveness of New Forest Parenting Programme (NFPP)-an individually delivered approach-with a group-based approach (incredible years, IY) and treatment as usual (TAU) in a sample group of preschool children with ADHD. Methods: The Comparison of Preschool Parenting Interventions (COPPI) trial was a three-arm parallel group, randomized controlled trial. The trial recruited 307 preschool children that met standard ADHD diagnostic criteria. Children were block-randomized to NFPP, IY, or TAU on a 3:3:1 ratio. NFPP is a specialist parent-training (PT) program for parents of preschool children with ADHD delivered on a one-to-one basis. The toddler version of IY is a group-based PT program delivered over 12-weekly sessions designed to address problems of challenging and oppositional conduct in young children. Results: In total, 307 participants were randomized (NFPP: N = 134; IY: N = 131; TAU: N = 42). The sample group included a high proportion of single parents (30 percent), low-income families, children with language difficulties (50 percent), and parents with mental health problems (77 percent). No statistically significant differences between NFPP and IY were observed in parent-assessed ADHD symptoms at T2 (primary end point: mean for NFPP, 1.715; mean for IY, 1.724; mean difference, -0.009; 95% CI -0.191 to 0.173; p = 0.921) or T3 or in other secondary or healthrelated outcomes at either T2 or T3. Small benefits of NFPP over TAU were seen for parent-rated ADHD (adjusted mean, 1.693 for NFPP and 1.881 for TAU; mean difference, -0.189; 95% CI -0.380 to 0.003; p = 0.053) and conduct problems (p < 0.05). NFPP was significantly less costly than IY (mean total cost per patient, 1,509 vs. 2,103), with the difference being attributed to higher intervention-related costs of IY. Cost utility analysis, in terms of incremental cost/quality-adjusted life-year (QALY) gained, showed that NFPP was dominant over IY and thus likely to be cost-effective, albeit based on small QALY gain differences. Conclusions: High-quality, group-based PT may be more expensive to deliver than some forms of individually delivered equally efficacious PT programs. Both formats should be available to families.
    Citation
    Daley, D. (2016). 45.1 efficacy and cost-effectiveness of individual versus group-based parent training for preschool attention-deficit/hyperactivity disorder: A multi-center randomized controlled trial. In: Martin, A., (Ed.) Scientific Proceedings of the 63rd Annual Meeting of the American Academy of Child and Adolescent Psychiatry, 24-29 October 2016 New York, United States. New York: Journal of the American Academy of Child and Adolescent Psychiatry, p.S330.
    Type
    Conference Proceeding
    URI
    http://hdl.handle.net/20.500.12904/7694
    Collections
    Schools and Other Educational Settings
    Attention Deficit Disorder

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