3.2 Engagement
At the end of data collection, 46 service users (40.7% of the sample) had been successfully titrated onto medication and discharged back to the care of their GP. A further 31 service users (27.4% of the sample) were still being titrated.
The remaining 36 service users (31.9% of the sample) did not complete titration and had been discharged from the service. Reasons for this were either the service user disengaging from the service (i.e. not attending appointments to complete titration) (19.5% of the sample), or not remaining on ADHD medication due to intolerable side effects (2.7%), a deterioration in their mental health which warranted a referral to another team (2.7%), substance abuse (0.9%) or concerns over cardiac health (3.5%). A further 3 service users (2.7%) decided against trialling ADHD medication before titration began. This cohort therefore did not complete post-treatment measures. Any pre-treatment measures recorded were included in the analyses.
As illustrated in table 1, when comparing the engagement of those who had recently been given an ADHD diagnosis and those previously diagnosed, a much higher proportion of those recently diagnosed had disengaged from the service (25.6% compared to 15.7%). However, the small sample size makes it difficult to draw any conclusions from this.
Weiss Functional Impairment Rating Scale (WFIRS)
Of the 113 service users in the sample, 69 had completed a pre-medication WFIRS. This gives a completion rate of 61.1%. By the cut-off date, 46 people had completed titration, with 26 of these completing the post-titration WFIRS. This gives a completion rate of 56.5% (or 23% of the overall sample).
Mean scores for each domain were calculated, with questions marked ‘not applicable’ being excluded. This scoring method enables a comparison between each domain, both pre- and post-titration. Table 2 illustrates the mean scores and standard deviations of each domain in the WFIRS, both pre- and post-titration on ADHD medication. The mean overall score pre-titration was 1.66 (SD=0.48), which decreased to 0.82 (SD=0.51) post-titration.
The results indicate that ADHD medication does significantly reduce the level of impairment experienced in all domains of the WFIRS. All areas were robust to Bonferroni correction for multiple comparisons where α was set to 0.5/7 or 0.007. Additionally, self-concept had the highest rated impairment (M=2.46, SD=0.62), and risky activities had the lowest (0.95, SD=0.79) before titration. Despite significant differences with post-titration mean scores, the highest and lowest rated domains for impairment remained the same.