OUTCOME MEASURES HIERARCHY FOR ATTENTION-DEFICIT HYPERACTIVITY DISORDER

Author(s)

Hormaechea-Beldarrain JA1, Prieto L21Hospital Quiron Bizkaia, Erandio, Spain, 2London School of Hygiene and Tropical Medicine, London, United Kingdom

OBJECTIVES: Attaining good patient health outcomes is the underlying purpose of any health care intervention, including drug therapy. METHODS: The outcome measure is the basis for evaluating the quality of health services, and a key element in determining the value of health interventions since the value of health care is defined as outcomes relative to cost. According to Porter (2010), value improvement starts with defining and measuring the total set of outcomes for a medical condition and determining the major risk factors. Porter has provided a challenging framework for identifying the full set of outcomes for any medical condition: the outcome measures hierarchy (OMH). RESULTS: According to the OMH the full set of outcomes for any medical condition, and its treatment, can be conveyed in a three-tiered hierarchy. Each tier of the hierarchy contains two broad levels, each of which involves one or more distinct outcome dimensions. Each medical condition should have its own outcome measures. Measurement efforts should begin with at least one outcome dimension at each tier, and ideally at each level. Possible outcome dimensions for Attention-Deficit Hyperactivity Disorder (ADHD) are explored and discussed according to Porter’s OMH. ADHD is a frequent neurobehavioral disorder that is characterised by inattention, hyperactivity and impulsivity. ADHD is associated with considerable social, family, behavioural and cognitive dysfunction, and is comorbid to depression, bipolar disorder, anxiety, and drug use. Specific dimensions proposed are aimed at capturing particular aspects of patients affected by ADHD. For each dimension, success is measured with several clinical and patient reported metrics. Tier 1 of the OMH is the patient’s health status achieved or retained after a health intervention (clinical or drug therapy). CONCLUSIONS: Tier 2 regards the process of recovery  and the eventual disutility of the treatment process. Tier 3 concerns the sustainability of health.

Conference/Value in Health Info

2011-11, ISPOR Europe 2011, Madrid, Spain

Value in Health, Vol. 14, No. 7 (November 2011)

Code

PRM68

Topic

Methodological & Statistical Research

Topic Subcategory

Confounding, Selection Bias Correction, Causal Inference

Disease

Mental Health, Multiple Diseases

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