Beneficios y riesgos de la discontinuación del tratamiento durante las vacaciones de verano en niños de edad escolar con trastorno por déficit de atención con hiperactividad
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Trastorno por déficit de atención con hiperactividad, estimulantes, vacaciones de tratamiento, Impresión Clínica Global de Gravedad, escala SNAP-IVResumen
En este estudio retrospectivo se evaluaron los beneficios y riesgos de la discontinuación del tratamiento farmacológico durante las vacaciones de verano (? 30 días) en 802 niños con trastorno por déficit de atención con hiperactividad (TDAH). En 440 de los pacientes (55%) se retiró el tratamiento durante el verano. El riesgo de mala adherencia (? 85%) fue más alto en los pacientes con vacaciones de tratamiento (odds ratio: 5,82). Comparados con los pacientes que recibieron tratamiento, los pacientes que no lo recibieron durante el verano tenían cuatro veces mayor probabilidad de empeorar o de no mejorar en la Escala de Impresión Clínica Global de Gravedad del TDAH (ICG-G-TDAH) (odds ratio 4,20, P < 0,0001). Además, los pacientes del grupo de vacaciones de tratamiento tenían tres veces mayor probabilidad de tener una puntuación > 1,67 en la escala de valoración SNAP-IV (odds ratio 2,60, P < 0,0001), y era más probable que sufrieran lesiones accidentales (odds ratio 1,49, P < 0,01), con un mayor número de lesiones por paciente (1,24 [DE = 3,67] frente a 0,8 [DE = 2,9], P = 0,05). Este análisis sugiere que las vacaciones del tratamiento en niños con TDAH pueden asociarse con resultados clínicos adversos.
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