The Meaning of Attention-Deficit/Hyperactivity Disorder Medication and Parents' Initiation and Continuity of Treatment for Their Child

Abstract

Objective: The aim of this study was to examine parents' early understanding of medication for attentiondeficit=hyperactivity disorder (ADHD) in relation to decisions to initiate and continue treatment for their child. Methods: Qualitative, semistructured telephone interviews were conducted with 48 parents of children newly diagnosed with ADHD. Parents were recruited from inner city, outpatient primary care, and mental health clinics affiliated with a large university hospital. Data were analyzed using grounded theory. Results: Parents' initial perspectives of the appropriateness, anticipated effects, and symbolic meaning of medication were classified by four typologies (illness oriented, problem oriented, generally acceptable, unacceptable). In this sample, 29% of parents believed medication was required to treat the illness and 20% believed medication was unacceptable. Except for the unacceptable group, nearly all of the parents in the other groups initiated medication shortly after diagnosis. More than 80% of the illness-and problem-oriented groups used medication at 6 months; this fell to 64% and 78%, respectively, at 12 months. Only half of the unacceptable group ever used medication for their child. Conclusions: Parents' views of ADHD medication may be predictive of continuity of treatment. Increasing physician awareness of parent preferences for managing their child's ADHD problems may lead to care management plans that maximize continuity.

Group Visits to Improve Pediatric Attention-Deficit Hyperactivity Disorder Chronic Care Management

“…Moreover, it is not uncommon for parents to question whether medications should be initiated in the first place or whether medications should continue to be used; they often receive conflicting messages from family and friends that may cause confusion [4][5][6][7] . Regardless of parental background and culture, parents desire more information about ADHD and the various treatment options that are available to support their children's learning, behavior and overall functioning [8][9][10] .…”

An Observational Study of Pharmacological Treatment in Primary Care of Children With ADHD in the United Kingdom

“…ADHD medication adherence is associated with child factors (such as age, gender, and disease severity) (18,19), parental factors (such as parental beliefs about pharmacotherapy) (17,20,21), and treatment factors (such as type, dosage, and side effects) (12)(13)(14)(15)(16). In particular, once-daily long-acting formulations have been consistently associated with longer treatment duration and continuity compared with the standard formulation (14)(15)(16)22).…”

Assessment of parents’ preferences for the treatment of school-age children with ADHD: a discrete choice experiment

“…As previously noted, agreement between the physician and the parents/child with regard to the objectives of ADHD therapy is essential for a positive outcome [13,16]. Parents and physicians face trade-offs regarding their treatment decisions, such as their expectations with regard to drug therapy are different and might not be restricted only to improved symptom control and/or reduced side effects.…”

“…Children with ADHD show improved compliance if they and their parents are able to relate to treatment objectives [15]. Agreement between the physician and the parents/child to the objectives of ADHD therapy is therefore also essential for a positive outcome [13,16].…”

“…Treating physicians may not be fully aware of the patient's and/or parent's expectations, attitudes or perceptions of treatments [16]. Clear communication between the various parties is key to achieving optimal clinical results using an SDM approach.…”