This new research, published in Pediatrics, and done by a team at the Children's Hospital of Philadelphia, focuses on shared decision-making by educated families and doctors for the best possible healthcare decisions.
The authors chose ADHD because of its frequent diagnosis and its two regular treatment options: prescription medication and behavioral therapy. Choosing the right treatment is crucial because the wrong treatment could lead to ineffective results. The researchers aimed to develop a tool to help families and healthcare professionals easily navigate this process.
Earlier research tells us that ADHD was diagnosed during 10.4 million physician outpatient visits this year, in children under the age of 18. Of the treatments prescribed during these visits, 87 percent of them used psychostimulants.
This current study involved 237 parents of children between the ages of 6 and 12 years who were diganosed with ADHD within the last 18 months. A combination of current research, parent interviews, and insight from parent advocates and professional experts, the authors put together a standardized three-part survey to aid parents in defining and ordering their goals for treatment; views on treatment; and assurance with behavioral therapies.
The finished questionnaire serves as a model to support families and healthcare professionals to achieve the most successful and manageable treatment for a child's ADHD.
Lead author Alexander Fiks, M.D., M.S.C.E, an urban primary care pediatrician at CHOP and a faculty member at CHOP's PolicyLab explains:
"It's important to know whether a parent's primary goal is to keep a child from getting in trouble at school, improve academic performance, or maintain more peace with family members or peers. We also need to learn about the family's lifestyle and attitudes toward behavioral therapy and medication. All of these factor into making the best treatment decision for each individual child and family."
Pediatric healthcare providers do not generally use shared decision making to measure families' selections and treatment goals for ADHD, but it is recommended by the Institute of Medicine and the American Academy of Pediatrics in order to pick the best possible treatment option.
A detailed survey may aid both patient-families and providers to feel more comfortable with their child's ADHD treatment. The authors say this is an encouraging design for a wider use in helping with treatment decisions for children with ADHD and could potentially be altered for use with other medical conditions.
Until their approach is widely recognized, Fiks and his team recommend the following questions for parents during their office visit for ADHD:
- What do you and your child want to achieve as a result of ADHD treatment?
-Better behavior or better grades at school
-More self-control at home
-Less teasing by other kids
- Consider your attitudes and your family's attitudes about medication and behavioral therapy, and why it may or may not be right for you.
-Write down questions about treatment options to ask during your appointment.
"For the pediatrician's part, it is our responsibility to fully inform parents about their options for treating ADHD and to seek guidance from families about which options will best meet their treatment goals and be manageable for their lifestyle. Research shows that patients adhere much better to the treatment options that they are comfortable with and that are the most practical for them. We need to make sure we're asking the right questions,"
Written by Kelly Fitzgerald