Health-related quality of life in children and adolescents with Duchenne muscular dystrophy and comorbid attention-deficit hyperactivity disorder using propensity-score matching

Objective: This study aimed to assess and compare the health-related quality of life (HRQoL) in a group of paediatric patients with Duchenne muscular dystrophy (DMD) with and without comorbid attention-deficit hyperactivity disorder (ADHD) diagnosis using a propensity-scoring method (PSM). Method: Data used in this study obtained from a cross-sectional and web-based survey to investigate the HRQoL for paediatric DMD patients. Data about those who diagnosed with ADHD was elicited for analysis. PSM was used to ensure generation of 1:5 matched pairs with no differences in several background characteristics between DMD patients with and without ADHD. Wilcoxon rank sum test and Multiple logistic regression models were used to measure the differences in HRQoL between matched DMD patients with and without ADHD. Results: After PSM, 630 DMD patients were assigned to the ‘No ADHD’ group, and successfully matched with another 126 DMD patients in the ADHD comparison group. Compared to DMD patients without ADHD, those with ADHD were more likely to report having symptoms and side-effects. Additionally, paediatric DMD patients with ADHD reported a significantly lower HRQoL on the subscales of emotional, social, and school functioning as compared to those without ADHD. Conclusion: This study demonstrated a higher burden of clinical symptoms, health service utilization, and psychosocial factors on HRQoL in DMD patients with ADHD compared to those without ADHD. Future studies using global data may provide meaningful comparisons with our results, and the efficacy of ADHD programs in DMD patients can be compared based on their HRQoL.