What influences clinicians’ decisions about ADHD medication? Initial data from the Influences on Prescribing for ADHD Questionnaire (IPAQ)

Abstract

Psychiatrists scored high on their focus on symptom control and preference for longterm medication use, while paediatricians reported using more rule-based approaches.We identified four distinctive response profiles: (i) pro-psychosocial; (ii) medication focused; (iii) unsystematic; and (iv) response optimizers. Future larger scale studies are required to replicate these profiles and to explore their relationship with prescribing behaviour and treatment outcomes.

Variation in Presentation, Diagnosis, and Management of Children and Adolescents With ADHD Across European Countries

“…This may lead to variability in the selection of pharmacotherapy or therapeutic modality across countries, which in turn may affect clinicians' ability to optimize ADHD treatment. Clinical guidelines change over time (Seixas et al, 2012), and the degree of adherence to national and international guidelines regarding ADHD diagnosis and treatment also varies, as demonstrated in the Decisions Regarding ADHD Management (DRAMa) study (Kovshoff et al, 2012) and the initial data from the Influences on Prescribing for ADHD Questionnaire (IPAQ) study (Kovshoff et al, 2013).…”

The effect of medication and question wording on self‐reported symptoms and their accuracy in young adults with attention‐deficit/hyperactivity disorder

“…IRS-Off scores were the only significant predictor of the ADHD symptoms most strongly targeted by medications: inattention and hyperactivity/restlessness. This is somewhat concerning given the role that self-reported symptomatology may play in managing patients' medications and treatment (Hill & Taylor, 2001;Kovshoff et al, 2013;National Institute for Health & Care Excellence, 2018;Steer, 2005). To the extent that practitioners or researchers administer questionnaires or interview their patients to evaluate the efficacy of current medications or other therapeutic approaches, our results indicate that, in the absence of specific instructions to consider the symptoms they experience when they are on their medications, young adults may over report their symptomatology by relying too much on what they are like when they are unmedicated.…”

“…Although discrepancies between subjective and objective cognitive abilities are not unique to patients with ADHD (see, for example, Feldman et al, 2018;Topiwala et al, 2020;Toyoshima et al, 2020), they are particularly relevant to this population because self-reports are an important component of effectively treating ADHD (Hill & Taylor, 2001;Kovshoff et al, 2013;National Institute for Health & Care Excellence, 2018;Steer, 2005). Self-reported symptomatology through clinical interviews or formal questionnaires is commonly used to evaluate medication efficacy, to assess the effectiveness of psychotherapeutic approaches, and to make decisions about future medication regimens (Hill & Taylor, 2001;Kovshoff et al, 2013;National Institute for Health & Care Excellence, 2018;Ramsay, 2017;Steer, 2005). Thus, understanding self-reported symptoms of young adults with ADHD who are prescribed and are taking medications to treat their symptoms has the potential to play a vital role in the proper treatment of these patients.…”

Informed Consent at Gunpoint: When Psychiatry Affects Gun Ownership

“…If history is any guide, psychiatrists are not always aware of the biases affecting their judgments. Studies of physician prescribing, diagnosis, and assessment have made clear that personal values consistently enter clinical and forensic evaluations (e.g., Kovshoff et al, ; Liebman & Burnette, ; Neighbors, Trierweiler, Ford, & Muroff, ). Mental health practitioners, like legal jurisdictions, will be influenced by the politics and values that inform the debate.…”