ADHD Remote Technology and ADHD Transition: Predicting and Preventing Negative Outcomes

Trial statusRecruiting
Trial phaseNot listed
Trial typeObservational
Biological sexAll
Age16-17
SponsorKing's College London

About this trial

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental condition affecting 5.9% of young people. Late adolescence can be a particularly challenging period for young people with ADHD, with major life transitions, new demands and increased expectations. This vulnerable phase also coincides with the transition from child and adolescent mental health care to adult ADHD services, where new UK data show that most young people with ADHD do not successfully transfer to adult services. Therefore, many young people with ADHD do not receive appropriate interventions at a time when they may need them most. Opportunities for intervention are currently not fully realised due to both the young people's disengagement from clinical services and our limited understanding of real-world targets for more holistic interventions. The current study seeks to address these needs using remote (not in-person) measurement technology (RMT). The MRC-funded project, ART-transition, will use the ADHD Remote Technology ('ART') assessment and monitoring assessments with young people with a diagnosis of ADHD aged 16-17 and the RADAR-base mobile-health platform to which it is linked. ART consists of active (e.g. questionnaires) and passive (e.g. sleep) smartphone app monitoring. In the study, the investigators will address three questions on the transition to adulthood for individuals with ADHD: what changes take place, what predicts them, and how can the investigators prevent negative outcomes and support healthy lifestyles? The investigators will remotely monitor 250 young people with ADHD over two years. The investigators will then co-design, with young people with ADHD, a prototype for a new ADHD-transition smartphone app. Our approach focuses on giving young people with ADHD greater autonomy in how they manage their ADHD, in collaboration with their clinician, and places the emphasis on modifiable environmental factors and the prevention of negative outcomes.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Diagnosis of DSM-5 ADHD

Aged 16-17

Able to give informed consent for participation

Willing and able to complete self-reported assessments via smartphone

Disqualifiers

Psychosis, currently experiencing a major depressive episode, mania, drug dependence in the last six months, or a major neurological disorder.

Recent contact with psychiatric acute care (admission, crisis team or liaison team (A&E) in the last six months

Any other major medical disease which might impact upon the patient's ability to participate in normal daily activities (e.g., due to hospitalisations)

Pregnancy

Trial population

Community and secondary care clinics

Trial design

Design model

Cohort

Time perspective

Prospective

Treatments tested in this trial

Not listed

Trial groups

500 Participants
are grouped into 2 trial groups
Group A: Adolescents with ADHD
Group B: Informant

Trial outcomes

Primary outcomes

1

ADHD symptoms and functional impairment

Barkley Adult ADHD Rating scale on symptoms and functional impairment (BAARS-IV)- Self Report. 29 items. For 18 items, individuals report the frequency with which they have experienced ADHD symptoms over the past two weeks on a four-point Likert Scale (0 = 'Never' or 'Rarely', 1 = 'Sometimes', 2 = 'Often', 3 = 'Very Often'). One item asks individuals to indicate the ages at which they first experienced symptoms. For the final 10 items, individuals report the extent to which their symptoms have interfered with their ability to function in various domains (e.g., home life or at work) on a four-point Likert Scale (0 = 'Never or Rarely', 1 = 'Sometimes', 2 = 'Often', 3 = 'Very Often').

Time frame
Baseline and every 4 weeks up to month 24
2

ADHD symptoms

Non-validated daily ADHD symptom question. 1 item. Individuals report the extent to which ADHD symptoms affected their daily activities on a Likert Scale (1 = Not at all, 2 = Slightly, 3 = Somewhat, 4 = Quite a lot, 5 = A lot).

Time frame
Baseline and every day up to month 24
3

Anxiety (General Anxiety Disorder-7, GAD-7)

7-items. 4-point Likert scale indicating the frequency of experiencing items in the past two weeks (0 = 'Not at all', 1 = 'Several days', 2 = 'More than half the days', 3 = 'Nearly every day'). Higher scores indicate higher severity of anxiety symptoms.

Time frame
Baseline and every 4 weeks up to month 24
4

Depression (Patient Health Questionnaire -8, PHQ-8, adapted)

8-items. 4-point Likert scale indicating the frequency of experiencing items in the past two weeks (0 = 'Not at all', 1 = 'Several days', 2 = 'More than half the days, 3 = 'Nearly every day'). Higher scores indicate higher severity of depression symptoms.

Time frame
Baseline and every 4 weeks up to month 24

Secondary outcomes

Other outcomes

Sponsors and contacts

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King's College London

Lead sponsor

South London and Maudsley NHS Foundation Trust

Collaborator

South West London and St George's Mental Health NHS Trust

Collaborator

Northamptonshire Healthcare NHS Foundation Trust

Collaborator