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Here, we assess WFIRS-P response in individual patients in two pivotal trials of lisdexamfetamine dimesylate (LDX) and guanfacine extended release (GXR). We also analysed pooled WFIRS-P data from seven phase 3 studies of ADHD medications to shed light on factors associated with baseline functional impairment. The proportion of patients with a change in WFIRS-P score that exceeded the minimal important difference (MID) criteria for response was greater for LDX than placebo in the Family, Learning and School, and Risky Activities domains, and was greater for GXR than placebo in the Social Activities, Learning and School, and Family domains. Responders had significantly worse baseline scores in all WFIRS-P domains (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) than non-responders. In the pooled analyses, baseline WFIRS-P scores in all domains were significantly worse in participants with oppositional defiant disorder (ODD) than in those without ODD. Having combined type or hyperactive-impulsive type ADHD, being enrolled into a study in Europe, being male and being younger also had modest negative effects on baseline WFIRS-P scores. The present analysis of WFIRS-P response shows that previously reported group-level improvements in WFIRS-P functional impairment score translated into clinically relevant improvements in many individual participants. Functional impairment is a diverse and subjective construct that is influenced by multiple factors. Optimal management of individuals with ADHD should involve monitoring improvements in functioning and quality of life, as well as symptomatic improvement.<\/jats:p>","DOI":"10.1007\/s00787-020-01586-5","type":"journal-article","created":{"date-parts":[[2020,7,20]],"date-time":"2020-07-20T06:03:41Z","timestamp":1595225021000},"page":"809-821","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Functional impairment outcomes in clinical trials of different ADHD medications: post hoc responder analyses and baseline subgroup analyses"],"prefix":"10.1007","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3017-9737","authenticated-orcid":false,"given":"David R.","family":"Coghill","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamara","family":"Werner-Kiechle","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sepehr","family":"Farahbakhshian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caleb","family":"Bliss","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brigitte","family":"Robertson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Huss","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,7,20]]},"reference":[{"key":"1586_CR1","doi-asserted-by":"publisher","first-page":"e0116407","DOI":"10.1371\/journal.pone.0116407","volume":"10","author":"LE Arnold","year":"2015","unstructured":"Arnold LE, Hodgkins P, Caci H, Kahle J, Young S (2015) Effect of treatment modality on long-term outcomes in attention-deficit\/hyperactivity disorder: a systematic review. 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Bliss, S. Farahbakhshian, B. Robertson and T. Werner-Kiechle are employees of Shire, a member of the Takeda group of companies, and are Takeda stock owners. The following authors have received compensation for serving as consultants or speakers, or they or the institutions they work for have received research support or royalties from the companies or organizations indicated: DR Coghill (Eli Lilly, Janssen-Cilag, Medice, Novartis, Oxford University Press and Shire [a member of the Takeda group of companies]); M Huss (Actelion, Eli Lilly, Engelhard Arzneimittel, Janssen-Cilag, Lundbeck, Medice, Novartis, Shire [a member of the Takeda group of companies] and Steiner Arzneimittel).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}