Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant


Physician Assistant Studies

Department Chair

John Cavenagh, PhD, PA-C


OBJECTIVE: The objective of this selective EBM review is to determine whether or not methylphenidate transdermal system (Daytrana®) is safe and effective for managing attention deficit hyperactivity disorder symptoms in children.

STUDY DESIGN: A review of three English language studies published from 2006-2010. Includes two randomized, double-blind, controlled trials and one randomized, controlled crossover study.

DATA SOURCES: Randomized, placebo-controlled studies evaluating the effectiveness and safety of methylphenidate transdermal system (MTS) for managing attention deficit hyperactivity disorder (ADHD) symptoms in children were located using the PubMed, CINAHL, and Cochrane Library databases.

OUTCOMES MEASURED: The primary measures of effectiveness used were the ADHD Rating Scale IV and SKAMP Teacher Rating Scale. The secondary measures of effectiveness were the Clinical Global Impressions-Improvement Scale and Parent’s Global Assessment. The measures of safety included adverse events (headache, anorexia, insomnia, gastrointestinal symptoms, abdominal pain, dizziness, etc.), skin reactions, vital signs, physical exam findings, EKG findings, and laboratory values.

RESULTS: Three randomized, controlled studies comparing MTS to a placebo transdermal patch were reviewed. All three studies found a statistically significant difference between the two treatment groups in the efficacy measurement scales, with evident improvement noted in MTS participants versus placebo. All three studies also found MTS to be well tolerated. The majority of adverse events were mild to moderate, and the most common events were decreased appetite, headache, gastrointestinal symptoms, and insomnia.

CONCLUSIONS: The results of all three studies in this review support a similar conclusion, that MTS is both effective and safe in the treatment of children 6-12 years of age diagnosed with ADHD. MTS provides the first non-oral administration of stimulant medication in the treatment of ADHD.