Consensus workshops on the development of an ADHD medication management protocol using QbTest: developing a clinical trial protocol with multidisciplinary stakeholders

Charlotte L Hall, Susan Brown, Marilyn James, Jennifer L Martin, Nikki Brown, Kim Selby, Julie Clarke, Laura Williams, Kapil Sayal, Chris Hollis, Madeleine J Groom, Charlotte L Hall, Susan Brown, Marilyn James, Jennifer L Martin, Nikki Brown, Kim Selby, Julie Clarke, Laura Williams, Kapil Sayal, Chris Hollis, Madeleine J Groom

Abstract

Background: The study design and protocol that underpin a randomised controlled trial (RCT) are critical for the ultimate success of the trial. Although RCTs are considered the gold standard for research, there are multiple threats to their validity such as participant recruitment and retention, identifying a meaningful change, and non-adherence to the protocol. For clinical RCTs, involving patients and clinicians in protocol design provides the opportunity to develop research protocols that are meaningful to their target audience and may help overcome some of the inherent threats in conducting RCTs. However, the majority of protocols do not describe the methodology underpinning their development, limiting the amount of learned experience shared between research groups.

Method: With the purpose of reporting a collaborative approach towards developing a protocol, we present the findings from three sequential workshops that were conducted with the aim of developing a protocol to investigate the feasibility of adding a computerised test of attention, impulsivity and activity (QbTest) to medication management of children and young people with Attention deficit hyperactivity disorder (ADHD). Based on previous qualitative interviews with clinicians and families, each workshop prioritised topics for focused discussion. Information from the workshops was fed back to the participants for reflection in advance of the next workshop.

Results: The workshops involved 21 multi-disciplinary ADHD experts, including clinicians, patient and public involvement (PPI) members, parents of young people with ADHD and researchers. The consensus workshops addressed key research issues such as: the most relevant outcome measures/ resource drivers; methods and time points for data collection; and the clinical protocol for utilising the QbTest, including when best to use this within the medication management process. The resulting protocol details a feasibility RCT design describing these factors.

Conclusion: Protocols which are co-developed may help overcome some of the risks associated with RCT completion (e.g. recruitment, retention, protocol adherence) and help prioritise outcomes of greater relevance to the populations under study. The methodology has potential value for researchers and organisations developing clinical guidelines, and offers insights into the valuable impact of PPI upon trial design.

Trial registration: Clinicaltrials.gov NCT03368573, 11th December 2017 (retrospectively registered).

Keywords: Expert workshop; Management; Medication; Patient and public involvement; Protocol development; QbTest; Titration.

Conflict of interest statement

On behalf of all authors, the corresponding author declares no conflicts of interests.

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Study Flow

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