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German population based long-term follow-up of ADHD

Description

The German Population Based Long Term Follow-Up of ADHD

The central aim of this study is to investigate the course of ADHD from childhood to adulthood considering therapy, comorbidities and further outcomes associated with ADHD. We based this study on pseudonymised health insurance data to facilitate the long term follow-up of children with and without ADHD which is an integral part of this study.
The study started with a pilot phase which was funded by the Federal Ministry of Education and Research (BMBF). Among other goals, this phase aimed to prove the suitability of health insurance data for a long term follow-up and to develop methods and tools for a further examination of aspects concerning ADHD in secondary claims data.

The pilot study had three parts:
I) In a pilot database cohort study we examined (based on health insurance data) children and youth with and without ADHD in the first 5 years after diagnosis. The study focused on the analysis of the disease burden, the frequency of injuries, the usage of the medical care system and the ADHD therapy. Various predictors such as gender, area of residence, age or social status of the parents were included in the analyses.
II) The second part of the study examined how drug treatment of children with ADHD influences the risk of injury by analysing those injuries which led to hospitalisation. The examination used a case-only design and was based on health insurance data.
III) The third part of the study explored the possibility of identifying insurance holders with and without ADHD in the database and of recruiting them for the study through a letter from their health insurance provider. A further goal of the study was the test of various instruments for a possible field study. This part of the study included a nationwide sample, identified from secondary health insurance data, as well as two regional samples with insurance holders from Bremen and Mannheim, also identified from health insurance data.

This study resulted in important information about frequency, therapy and predictors of the course of ADHD and the therapy of ADHD in Germany as well as the influence of drug treatment on the risk of injury of children with ADHD. Consequently, the study reached its goals. An examination of secondary health insurance data has thus proven a promising option for further studies about ADHD. By contrast, recruitment of children with ADHD through their health insurance provider has proven less promising. Aside from considerable administrative hurdles which had to be overcome, the response rate was low.

The pilot database study had a follow-up of 5 years which was longer than originally planned in the study proposal. Nonetheless, the follow-up is not sufficient to evaluate the course of ADHD into adulthood. Therefore, a self-financed continuation of the database study until 2016 including health insurance data from 2004 to 2015 has already been planned and approved by the health insurance providers and the governing authorities. This will extend the actual follow-up by 6 years.

Funding period

Begin:   January 2009
End:   December 2017

Sponsor

  • Federal Ministry of Education and Research

Contact

Dr. rer. nat. Ingo Langner

Cooperation

  • AOK Bremen/Bremerhaven
  • Deutsche Angestellten-Krankenkasse (DAK)
  • Handelskrankenkasse (HKK)
  • Techniker Krankenkasse (TK)
  • Prof. Dr. Dr. Tobias Banaschewski (Zentralinstitut für Seelische Gesundheit, Mannheim)
  • Prof. Dr. Ulrike Petermann (Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen)
  • Prof. Dr. Franz Petermann (Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen)
  • Prof. Dr. Marcella Rietschel (Zentralinstitut für Seelische Gesundheit, Mannheim)

Link

Webpage of the Pilotstudy of the German Population Based Long Term Follow-Up of ADHD

Selected project-related publications

    Articles with peer-review

  • Mikolajczyk R, Horn J, Schmedt N, Langner I, Lindemann C, Garbe E. Injury prevention by medication among children with attention-deficit/hyperactivity disorder: A case-only study. JAMA Pediatrics. 2015;169(4):391-395.
    https://doi.org/10.1001/jamapediatrics.2014.3275
  • Kraut A, Langner I, Lindemann C, Banaschewski T, Petermann U, Petermann F, Mikolajczyk R, Garbe E. Comorbidities in ADHD children treated with methylphenidate: A database study. BMC Psychiatry. 2013;13:11.
    https://doi.org/10.1186/1471-244X-13-11
  • Langner I, Garbe E, Banaschewski T, Mikolajczyk R. Twin and sibling studies using health insurance data: The example of attention deficit/hyperactivity disorder (ADHD). PLOS ONE. 2013;8(4):e62177.
    https://doi.org/10.1371/journal.pone.0062177
  • Garbe E, Mikolajczyk R, Banaschewski T, Petermann U, Petermann F, Kraut A, Langner I. Drug treatment patterns of attention deficit/hyperactivity disorder in children and adolescents in Germany: Results from a large population-based cohort study. Journal of Child and Adolescent Psychopharmacology. 2012;22(6):452-458.
    https://doi.org/10.1089/cap.2012.0022
  • Lindemann C, Langner I, Kraut A, Banaschewski T, Schad-Hansjosten T, Petermann U, Petermann F, Schreyer-Mehlhop I, Garbe E, Mikolajczyk R. Age-specific prevalence, incidence of new diagnoses and drug treatment of attention-deficit / hyperactivity disorder in Germany. Journal of Child and Adolescent Psychopharmacology. 2012;22(4):307-314.
    https://doi.org/10.1089/cap.2011.0064
  • Presentations at scientific meetings/conferences

  • Langner I, Lindemann C, Kraut A, Garbe E, Mikolajczyk R. Regionale Heterogenität der Prävalenz von Aufmerksamkeitsdefizit/Hyperaktivitätsstörung (ADHS)-Diagnosen bei Kindern und Jugendlichen in Deutschland. 57. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (GMDS), 16.-21. September 2012, Braunschweig.
  • Langner I, Lindemann C, Mikolajczyk R, Garbe E. Inanspruchnahme von stationärer und ambulanter ärztlicher Versorgung bei Kindern und Jugendlichen mit Aufmerksamkeitsdefizit/Hyperaktivitätsstörung (ADHS) in Deutschland. 57. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (GMDS), 16.-21. September 2012, Braunschweig.
  • Lindemann C, Langner I, Heuer D, Mikolajczyk R, Garbe E. Erhöhtes Verletzungsrisiko von Kindern mit Aufmerksamkeitsdefizit-/ Hyperaktivitätsstörung: Eine gematchte Kohortenstudie. 57. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (GMDS), 16.-21. September 2012, Braunschweig.
  • Mikolajczyk R, Horn J, Langner I, Lindemann C, Garbe E. Accidents prevention by methylphenidate among children with ADHS - Insights from case-crossover and self-controlled case series designs. 57. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (GMDS), 16.-21. September 2012, Braunschweig.
  • Kraut A, Langner I, Mikolajczyk R, Lindemann C, Garbe E. Comorbidities in methylphenidate users compared to nonusers in Germany. "Biometrie, Epidemiologie und Informatik - Gemeinsam forschen für Gesundheit". 56. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (GMDS) und 6. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi), 26-29 September 2011, Mainz.
  • Langner I, Jobski K, Mikolajczyk R, Kraut A, Garbe E. Methylphenidate and atomoxetine treatment of ADHD in children and youths in Germany. "Biometrie, Epidemiologie und Informatik - Gemeinsam forschen für Gesundheit". 56. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (GMDS) und 6. Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi), 26-29 September 2011, Mainz.
  • Langner I, Lindemann C, Kraut A, Mikolajczyk R, Garbe E. Incidence and prevalence of ADHD diagnoses in children and adolescents in Germany in 2005: A database study. Kongress "Individualisierte Prävention und Epidemiologie: Die moderne Medizin". Gemeinsame Jahrestagung der Deutschen Gesellschaft für Epidemiologie (DGEpi), der Deutschen Gesellschaft für Sozialmedizin und Prävention (DGSMP) und der European Union of Medicine in Assurance and Social Security (EUMASS), 21.-25. September 2010, Berlin.
  • Lindemann C, Kraut A, Mikolajczyk R, Garbe E. Methylphenidate treatment in Germany - Are co-morbidities taken into account? 26th International Conference on Pharmacoepidemiology & Therapeutic Risk Management (ICPE), 19.-22. August 2010, Brighton, United Kingdom.
  • Posters at scientific meetings/conferences

  • Lindemann C, Langner I, Kraut A, Mikolajczyk R, Garbe E. Regionale Unterschiede in der Häufigkeit der ADHS-Diagnosen in Deutschland. 4. Methodenworkshop der Arbeitsgruppe Erhebung und Nutzung von Sekundärdaten (AGENS) der Deutschen Gesellschaft für Sozialmedizin und Prävention (DGSMP) und der Deutschen Gesellschaft für Epidemiologie (DGEpi), 22.-23. März 2012, Bremen.
  • Garbe E, Mikolajczyk R, Kraut A, Langner I. Drug treatment of ADHD in children and youths in Germany. 27th International Conference on Pharmacoepidemiology & Therapeutic Risk Management (ICPE), 14-17 August 2011, Chicago, USA. (Abstract published in: Pharmacoepidemiology & Drug Safety. 2011;20(Suppl.1):132)