Benefits of ADHD Treatment in Detained People

NCT ID: NCT05842330

Last Updated: 2025-07-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-01-01

Study Completion Date

2026-10-30

Brief Summary

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Attention deficit hyperactivity disorder (ADHD) is characterized by difficulties paying attention, poor impulse control, and hyperactive behaviors. It is associated with several health and social detrimental outcomes and leads to increased risks of criminality and recidivism. However, to date, ADHD treatment has been neglected in prison. This project will test the efficacy of ADHD treatment using a randomized controlled trial.

Detailed Description

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This project aims to compare the efficacy of a three-month in-prison OROS-methylphenidate vs. placebo treatment on the severity of ADHD core symptoms. Secondary outcomes address additional important in-prison and outpatient (in-prison or post-prison) aspects: 1) reduction in acute events in prison (e.g., disciplinary sanctions, violence, misuse of ADHD treatment), 2) evaluation of the risk of recidivism upon release, 3) three-month side effects of treatment, 4) in- and post-prison adherence to medication, 5) in- and post-prison study retention, 6) in- and post-prison costs-benefits of treatment, and 8) one-year rule-breaking behaviour. The outpatient part of the project will highlight long-lasting benefits of a treatment provided during three months while people are detained.

These research questions will be answered using a randomized controlled trial. After randomization, the participants will undertake three months of treatment with OROS-MPH or placebo (1:1 ratio) while they are incarcerated. After three months, all participants will be offered the possibility to have the treatment, but they will remain blinded regarding their initial study group. All of them will benefit of a cognitive-behavioral psycho-education program during detention and a cognitive-behavioral therapy after release.

The RCT will provide empirical-based evidence of the benefits of in-prison ADHD treatment using different perspectives: Clinical, behavioral, rule-breaking-related, and economical. The investigators expect that early detection and treatment of ADHD in prison will be an important public health opportunity and a cost-effective approach, likely to decrease the vulnerability of people living in detention and to promote pathways out criminal involvement.

Conditions

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ADHD

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This is a phase 3 parallel randomized controlled trial (1:1 ratio) of OROS-MPH vs. a placebo on a clinical outcome.

Participants will undertake three months (12 weeks) of treatment while they are incarcerated. After three months, all participants will be offered treatment in outpatient care, either in prison or in the community. They will have daily monitoring of medical adherence in prison or in electronic monitors after release (without being unblinded on the treatment they received during detention). They will be followed-up for twelve months as outpatient care (total study duration: 15 months).
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors
Participants will be blinded to the 3-month (12 weeks) in-prison treatment. The research team and statistician will be blinded to the participants' group. The psychiatrist will be unblinded when participants are released. At that time of the study, all participants will be offered to have the treatment (OROS-MPH) without being unblinded regarding their initial group.

Study Groups

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Pharmaceutical intervention (OROS-MPH)

Participants will receive OROS-MPH (Concerta® available in Switzerland as first-line treatment for ADHD). Dosages will be defined according to the Swiss Compendium. The psychiatrist (blinded during detention) will start with the smallest dosage (18 mg, Concerta®). The treatment will be monitored weekly the first month, and then monthly. The pharmacy of the Geneva University Hospitals will be in charge of over-encapsulating medications.

Group Type EXPERIMENTAL

Concerta

Intervention Type DRUG

Dosages of Concerta® will be defined according to the Swiss Compendium (from 18 to 72 mg/d).

The psychiatrist will start with the smallest dosage (18 mg) and will adapt it on a weekly basis or on need, depending on tolerance (side effects measured at each visit), clinical response (subjective improvement felt by the patient in terms of attention, impulsivity, and hyperactivity), and according to the observations made by the professionals or patient's entourage in term of attention, impulsivity, hyperactivity, and for this project, behavioral problems. In general, the dose can be increased in 18 mg at weekly intervals.

The treatment will be monitored weekly the first month, and then monthly, except for side effects which will be monitored daily in prison and every two weeks after release.

Placebo

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

The placebo will be strictly identical (same packaging, size no. 2 and color according to dosage, with no label).

Procedure for adjustment of dosage will be the same as in the Concerta arm.

Interventions

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Concerta

Dosages of Concerta® will be defined according to the Swiss Compendium (from 18 to 72 mg/d).

The psychiatrist will start with the smallest dosage (18 mg) and will adapt it on a weekly basis or on need, depending on tolerance (side effects measured at each visit), clinical response (subjective improvement felt by the patient in terms of attention, impulsivity, and hyperactivity), and according to the observations made by the professionals or patient's entourage in term of attention, impulsivity, hyperactivity, and for this project, behavioral problems. In general, the dose can be increased in 18 mg at weekly intervals.

The treatment will be monitored weekly the first month, and then monthly, except for side effects which will be monitored daily in prison and every two weeks after release.

Intervention Type DRUG

Placebo

The placebo will be strictly identical (same packaging, size no. 2 and color according to dosage, with no label).

Procedure for adjustment of dosage will be the same as in the Concerta arm.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* age between 18 and 65
* good command of French
* stay in prison approx. 4 months at eligibility visit
* endorsing clinical diagnostic criteria for DSM-5 ADHD
* providing written informed consent

Exclusion Criteria

* presence of an acute uncontrolled comorbid psychiatric disorder
* medical contraindication to stimulant prescription
* potential adverse interaction with another medication
* already receive ADHD treatment
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Lausanne

OTHER

Sponsor Role collaborator

University of Geneva, Switzerland

OTHER

Sponsor Role collaborator

Netherlands Institute for the Study of Crime

UNKNOWN

Sponsor Role collaborator

School of Health Sciences Fribourg

UNKNOWN

Sponsor Role collaborator

Stéphanie Baggio

OTHER

Sponsor Role lead

Responsible Party

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Stéphanie Baggio

Prof.

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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Geneva University Hospitals

Geneva, Canton of Geneva, Switzerland

Site Status RECRUITING

Countries

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Switzerland

Facility Contacts

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Patrick Heller, MD

Role: primary

+41223055218

References

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Baggio S, Billieux J, Dirkzwager A, Iglesias K, Moschetti K, Perroud N, Schneider M, Vernaz N, Wolff H, Heller P. Protocol of a monocentric, double-blind, randomized, superiority, controlled trial evaluating the effect of in-prison OROS-methylphenidate vs. placebo treatment in detained people with attention-deficit hyperactivity disorder (BATIR). Trials. 2024 Jan 4;25(1):23. doi: 10.1186/s13063-023-07827-7.

Reference Type DERIVED
PMID: 38178233 (View on PubMed)

Other Identifiers

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32003B_212581

Identifier Type: -

Identifier Source: org_study_id

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