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Caregivers' Priorities and Observed Outcomes of Attention-Deficit Hyperactivity Disorder Medication for Their Children

Ross, Melissa, PhD*; Nguyen, Vy, PharmD*; Bridges, John F., P., PhD; Ng, Xinyi, PhD*; Reeves, Gloria, MD; Frosch, Emily, MD§; dosReis, Susan, PhD*

Journal of Developmental & Behavioral Pediatrics: February/March 2018 - Volume 39 - Issue 2 - p 93–100
doi: 10.1097/DBP.0000000000000530
Original Articles

Objective: To document variability among caregivers' priorities when considering medication to treat their Children's attention-deficit hyperactivity disorder (ADHD) and explore associations between these priorities and medication-related improvements.

Methods: Caregivers of children, ages 4 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.

Results: The 184 participants (mean = 42 yrs) 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 < 0.0001), school behavior improvements (p < 0.0001), and better grades (p < 0.0001). Others thinking badly of the child was a significantly less important concern (p < 0.0001). Three subgroups were identified: short-term outcomes-oriented group (39%), long-term outcomes-oriented group (37%), and side effects/safety-oriented group (27%). Relative to the other 2 groups, a smaller proportion of the side effects/safety-oriented group desired these improvements (p < 0.2618).

Conclusion: 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.

*Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD;

Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD;

Department of Psychiatry, Division of Child and Adolescent Psychiatry, University of Maryland School of Medicine, Baltimore, MD;

§Department of Psychiatry, Division of Child and Adolescent Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD.

Address for reprints: Susan dosReis, PhD, Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, 220 Arch St, Baltimore, MD 21201; e-mail:

Supported by a grant from the National Institute of Mental Health (R34 MH093502; PI: S. dosReis).

Disclosure: The authors declare no conflict of interest.

Received June 27, 2017

Accepted October 05, 2017

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.