Caregivers' Priorities and Observed Outcomes of Attention-Deficit Hyperactivity Disorder Medication for Their Children.
Caregivers' Priorities and Observed Outcomes of Attention-Deficit Hyperactivity Disorder Medication for Their Children.
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DOI：
10.1097/dbp.0000000000000530
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
dosReis S
中科院分区：
文献类型：
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作者：
Ross M;Nguyen V;Bridges JFP;Ng X;Reeves G;Frosch E;dosReis S
记录照顾者在考虑药物治疗儿童注意力缺陷/多动障碍（ADHD）时的优先事项之间的差异，并探索这些优先事项与药物相关改善之间的关联。从马里兰州的门诊诊所和支持团体招募了被诊断为多动症的4至14岁儿童的照顾者。一项调查收集了关于儿童在考虑ADHD药物治疗、人口统计学特征以及观察到的和期望的ADHD改善时所报告的担忧的数据。一个经过验证的最佳最差缩放工具评估了考虑ADHD药物治疗时16个问题的优先级。潜在类别分析确定了具有类似ADHD药物问题的亚组。检查了各亚组之间自我报告的药物相关改善的差异。184名参与者（平均年龄=42岁）主要是亲生母亲，68%为白色，25%为黑人。他们的孩子大多是男性（73%），使用药物（81%）。总体而言，最重要的ADHD药物治疗问题是孩子成为一个成功的成年人（p<.0001），学校行为改善（p<.0001）和更好的成绩（p<.0001）。其他人认为孩子不好是一个不太重要的问题（p<0.0001）。确定了三个亚组：短期结果导向（39%），长期结果导向（37%）和副作用/安全性导向（27%）。相对于其他两组，副作用/安全导向组中希望这些改善的比例较小（p<0.2618）。大多数照顾者在考虑ADHD药物时优先考虑短期和长期结果。然而，那些最关心长期或短期结果的人倾向于希望他们孩子的ADHD得到进一步的改善。
To document variability among caregivers’ priorities when considering medication to treat their child’s attention-deficit/hyperactivity disorder (ADHD) and explore associations between these priorities and medication-related improvements. Caregivers of children, ages four to 14-years, diagnosed with ADHD were recruited from outpatient clinics and support groups across Maryland. A survey gathered data on caregiver-reported concerns when considering ADHD medication, demographic characteristics, and observed and desired improvements in their child’s ADHD. A validated best-worst scaling instrument assessed priorities among 16 concerns when considering ADHD medication. Latent class analysis identified subgroups with similar ADHD medication concerns. Differences in self-reported medication-related improvements were examined across subgroups. The 184 participants (mean=42 years) were primarily the biological mother, 68% white and 25% black. Their children were mostly male (73%) and using medication (81%). Overall, the most important ADHD medication concerns were the child becoming a successful adult (p<.0001), school behavior improvements (p<.0001), and better grades (p<.0001). Others thinking badly of the child was a significantly less important concern (p<.0001). Three subgroups were identified: short-term outcomes-oriented (39%), long-term outcomes-oriented (37%), and side-effects/safety-oriented (27%). Relative to the other two groups, a smaller proportion of the side-effects/safety-oriented group desired these improvements (p<0.2618). Most caregivers prioritize short- and long-term outcomes when considering ADHD medication. However, those most concerned with long- or short-term outcomes tended to desire additional improvements in their child’s ADHD.