N of 1 trials. Practical tools for medication management

Aust Fam Physician. 2000 Nov;29(11):1108-12.

Abstract

Background: In single patient (n of 1) trials, a patient acts as his or her own control in a study comparing the effectiveness of a drug with placebo or another drug. The aim of a single patient trial (SPT) is to identify the best treatment for the individual patient, formalising a 'trial of treatment' by using blinding and multiple crossover periods.

Objective: We have successfully piloted SPTs for osteoarthritis and attention deficit hyperactivity disorder, and several others are currently being piloted. Barriers encountered include: obtaining identical placebos, ethical approval for individual SPTs, standardising doses, determining length of treatment periods, patient withdrawals and cost of the SPTs.

Discussion: Only prescribing medications if an individual has been shown to be a responder can greatly benefit general practitioners, patients and the healthcare system. We have established the infrastructure necessary to offer a single patient trial service to GPs and patients anywhere in Australia. This has the potential to revolutionise prescribing for certain chronic conditions.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage*
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Australia
  • Central Nervous System Stimulants / administration & dosage*
  • Controlled Clinical Trials as Topic
  • Humans
  • Osteoarthritis / drug therapy*
  • Patient Selection
  • Pilot Projects
  • Sensitivity and Specificity

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Central Nervous System Stimulants