A multitude of indirect measures of adherence exist in the literature, however, there is no "gold" standard for measuring adherence to medications. Triangulation of methods increases the validity and reliability of the adherence data collected. To strengthen the adherence data collected and allow for comparison of data, future research and practice interventions should use an internationally accepted, operational standardized definition of medication adherence and clearly describe the medication adherence methods used.
Suboptimal adherence to treatment regimens is a major obstacle to treatment efficacy and positive outcomes for patients. While poor adherence is common across a variety of chronic conditions, an area which presents unique challenges to clinicians and researchers is non-adherence among pediatric populations. These challenges are well illustrated by the management of attention-deficit/hyperactivity disorder (ADHD), a pervasive pediatric psychiatric condition. The average rates of non-adherence in children and adults ranged between 15 and 87%. Factors predicting increased adherence/persistence included the use of long-acting formulations, younger age, Caucasian background, family structure and the presence and treatment of comorbidities. Decreased adherence/persistence were predicted by multiple daily dosing, family history of ADHD, experiences of adverse effects, stigma and treatment inefficacy. The broad range of non-adherence rates identified reflects the complexities of adherence research in ADHD, and highlights the need for better standardization of adherence/persistence definitions and measurement approaches.
BackgroundAttention-deficit/hyperactivity disorder (ADHD) is the most prevalent pediatric neurodevelopmental condition, commonly treated using pharmacological agents such as stimulant medicines. The use of these agents remains contentious, placing parents in a difficult position when deciding to initiate and/or continue their child’s treatment. Parents refer to a range of information sources to assist with their treatment decision-making. This qualitative study aimed to investigate 1) parents’ ADHD-related knowledge pre- and post-diagnosis, 2) the information sources accessed by parents, 3) whether parents’ information needs were met post-diagnosis, and 4) parents’ views about strategies to meet their information needs.MethodsThree focus groups (n=16 parents), each lasting 1.0–1.5 hours were conducted. Focus groups were audio-recorded and transcribed verbatim. Transcripts were analyzed using the framework method, coded, and categorized into themes.ResultsGenerally, parents had limited ADHD-related knowledge prior to their child’s diagnosis and perceived prescription medicines indicated for ADHD in a negative context. Parents reported improved knowledge after their child’s diagnosis; however, they expressed dissatisfaction with information that they accessed, which was often technical and not tailored to their child’s needs. Verbal information sought from health care professionals was viewed to be reliable but generally medicine-focused and not necessarily comprehensive. Parents identified a need for concise, tailored information about ADHD, the medicines used for its treatment, and changes to their child’s medication needs with age. They also expressed a desire for increased availability of support groups and tools to assist them in sourcing information from health care professionals during consultations, such as question prompt lists.ConclusionThere are gaps in parents’ knowledge about ADHD and its treatment, and an expressed need for tailored and reliable information. Future research needs to focus on providing parents with avenues to access concise, reliable, and relevant information and support in order to empower them to make the best treatment decision for their child.
Objectives Question prompt lists (QPLs) are structured lists of disease and treatment-specific questions intended to encourage patient question-asking during consultations with clinicians. The aim of this study was to develop a QPL intended for use by parents of children affected by attention-deficit/hyperactivity disorder (ADHD).Methods The QPL content (111 questions) was derived through thematic analysis of existing ADHD-and QPL-related resources. A modified Delphi method, involving a three-round web-based survey, was used to reach consensus about the QPL content. Thirty-six experts were recruited into either a professional [paediatricians, child and adolescent psychiatrists, psychologists, researchers (n =28)] or non-professional panel [parents of children diagnosed with ADHD, ADHD consumer advocates (n = 8)]. Panel members were asked to rate the importance of the QPL content using a five-point scale ranging from 'Essential' to 'Should not be included'.Results A total of 122 questions, including 11 new questions suggested by panellists, were rated by both panels. Of these, 88 (72%) were accepted for inclusion in the QPL. Of the accepted questions, 39 were re-rated during two follow-up survey rounds and 29 (74%) were subsequently accepted for inclusion. The questions covered key topics including diagnosis, understanding ADHD, treatment, health-care team, monitoring ADHD, managing ADHD, future expectations and support and information.Conclusions To our knowledge, this is the first ADHD-specific QPL to be developed and the first use of the Delphi method to validate the content of any QPL. It is anticipated that the QPL will assist parents in obtaining relevant, reliable information and empowering their treatment decisions by enhancing the potential for shared decision making with clinicians.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.