Academic journal article Journal of Child and Adolescent Psychopharmacology

Caregiver Treatment Preferences for Children with a New versus Existing Attention-Deficit/Hyperactivity Disorder Diagnosis

Academic journal article Journal of Child and Adolescent Psychopharmacology

Caregiver Treatment Preferences for Children with a New versus Existing Attention-Deficit/Hyperactivity Disorder Diagnosis

Article excerpt

[Author Affiliation]

Susan dosReis. 1 Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Maryland.

Alex Park. 1 Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Maryland.

Xinyi Ng. 1 Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, Maryland.

Emily Frosch. 2 Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Gloria Reeves. 3 Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland.

Charles Cunningham. 4 Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario Canada.

Ellen M. Janssen. 5 Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.

John F.P. Bridges. 5 Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland.

Funding: This research was supported by a grant from the National Institute of Mental Health (MH093502; PI: S.d.R.).

Address correspondence to: Susan dosReis, PhD, Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, 220 Arch Street, 12th Floor, Baltimore, MD 21201, E-mail: sdosreis@rx.umaryland.edu

Introduction

Attention-deficit/hyperactivity disorder (ADHD) is reported among 10% (6.4 million) U.S. children and adolescents and half, or 3.5 million, use first-line stimulant medication (Visser et al. 2014). ADHD is the only neurodevelopmental childhood disorder with a treatment that has an extensive evidence base from clinical trials. However, there has been relatively poor adherence to treatment (Adler and Nierenberg 2010) even though, for many children, ADHD is a chronic condition. Often treated in pediatric practice (Goodwin et al. 2001), the American Academy of Pediatrics supports management by primary care providers, care planning guided by patient/family preferences (Committee on Psychosocial Aspects of Child and Family Health and Task Force on Mental Health 2009; Wolraich et al. 2011), and treatment outcomes elicited by families' and children's priorities (Foy 2010).

A better understanding of the issues that most influence patients and families is needed (Nielsen 2014). For one, although stimulants to reduce hyperactivity/impulsivity and inattention and parent training to manage the child's ADHD behaviors at home are supported by randomized, controlled clinical trials and are emphasized in evidence-based guidelines (American Academy of Child and Adolescent Psychiatry 2002; Wolraich et al. 2011), families often prefer nonpharmacologic alternatives, avoiding stimulants until all other efforts have failed (Bussing et al. 2002; Leslie et al. 2007; dosReis et al. 2009; Coletti et al. 2012; Davis et al. 2012). Previous research demonstrates that caregivers of children newly diagnosed with ADHD are coming to terms with how to best manage the behaviors for up to four years (dosReis et al. 2007, 2009). Moreover, practice guidelines are specific to the care management of children as young as four to five years old, yet studies on parent preferences for ADHD treatment generally focus on children aged six years and older and those newly diagnosed rather than those who have been in care for several years (Waschbusch et al. 2011; Fiks et al. 2013). Additionally, the communication between pediatricians, mental health specialists, and school personnel for ADHD care management can be challenging for providers and families (Lynch et al. 2015).

The purpose of the present study was to elicit from the caregiver the relative preference for the components of an ADHD treatment plan, which consisted of seven different care management attributes (i. …

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