Parent goals influence ADHD treatment choices

ADHD symptoms stable in early life despite meds
ADHD symptoms stable in early life despite meds

HealthDay News -- Parents with strong treatment preferences and specific goals for treating their child's attention deficit hyperactivity disorder (ADHD) were more likely to initiate treatment earlier and use distinct methods to achieve their goals, study findings suggest.

Having a preference for therapy type at baseline was associated with a greater than two-fold odds of treatment initiationt -- 2.6-fold for medication (95% CI 1.2-5.5) and 2.2-fold for behavioral therapy (95% CI 1.0-5.1) -- Alexander G. Fiks, MD, from the Children's Hospital of Philadelphia, and colleagues reported in Pediatrics.

Additionally, parents of children with ADHD are more likely to choose medication if the goal is academic achievement (OR 2.1), but more likely to choose behavior therapy if the goal is behavioral compliance (or 1.6), the researchers found.

Fiks and colleagues surveyed 148 parents or guardians of children 6 to 12 years old who were diagnosed with ADHD in the 18 months prior to the study and were not receiving both behavior therapy and medication at the time of enrollment, regarding their treatment preferences and goals.

Participants completed the ADHD Preference and Goal Instrument, which asked about medication and behavior therapy preferences and included goal scales. Outcome data were measured 6 months after baseline.

Among the 108 children who were not receiving medication at baseline, 43% had initiated medication at 6-month follow-up. Among the 124 not receiving behavioral therapy at baseline, 24% had initiated it during the study period. Among participants who initiated either treatment type, one discontinued medication and eight discontinued behavior therapy.

Parents who indicated a preference for medication at baseline had a 2.6-fold increase in the likelihood of initiating a drug therapy, and those who scored higher on not having a concern regarding medication side effects were 1.5 times more likely to start a medication (95% CI: 1.0-2.2). 

Findings were similar for behavior therapy. Those who indicated a preference for behavior therapy at baseline were 2.2 times more likely of initiating such therapy, and fears about adverse events did not deter treatment initiation.

After six months, parents appeared to have achieved their goals, since they had reduced academic and behavioral goals.

"Supporting the clinical utility of preference and goal assessment, we found that parental treatment preferences are associated with treatment initiation, and those with distinct goals select different treatments," the researchers concluded.


References

  1. Fiks AG et al. Pediatrics. 2013; doi: 10.1542/peds2013-0152.
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