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What influences clinicians’ decisions about ADHD medication? Initial data from the "influences on prescribing for ADHD questionnaire" (IPAQ)

What influences clinicians’ decisions about ADHD medication? Initial data from the "influences on prescribing for ADHD questionnaire" (IPAQ)
What influences clinicians’ decisions about ADHD medication? Initial data from the "influences on prescribing for ADHD questionnaire" (IPAQ)
Despite evidence for its efficacy and effectiveness, the use of medication for the treatment of ADHD remains controversial. Little is known about the factors that influence clinicians’ decisions to use medication for ADHD. Here, we present initial data on the attitudes of prescribing clinicians from the Influences on Prescribing for ADHD Questionnaire (IPAQ)—a new clinician-completed, 40-item scale. The eight IPAQ subscales cover attitudes towards (1) treatment outcome optimisation, (2) the use of rule based over more informal approaches, (3) side effects, (4) symptoms control as the primary goal of treatment, (5) the influence of external pressure on medication-related decisions, (6) the value of taking the child’s views into account, (7) long-term medication use and (8) the value of psychosocial approaches for the treatment of ADHD. Sixty-eight clinicians from Belgium and the UK took part. All subscales had acceptable levels of internal reliability (Chronbach’s alpha = 0.62–0.78). Overall, clinicians reported taking a rule-based approach to prescribing with a focus on treatment optimisation, taking the child’s view into account and valuing psycho-social approaches. They focused on treating broader patterns of impairment, but were wary of the potential side effects and long-term treatment. Psychiatrists scored high on their focus on symptom control and preference for long-term medication use, while paediatricians reported using more rule-based approaches. We identified four distinctive response profiles: (1) pro-psychosocial; (2) medication focused; (3) unsystematic; and (4) response optimizers. Future larger scale studies are required to replicate these profiles and to explore their relationship with prescribing behaviour and treatment outcomes.
1018-8827
Kovshoff, Hanna
82c321ee-d151-40c5-8dde-281af59f2142
Vrijens, May
f6327e12-080f-47df-b6e5-4d587abc0045
Thompson, Margaret
bfe8522c-b252-4771-8036-744e93357c67
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Hodgkins, Paul
9bfa108c-b193-418d-9f4b-51f09a1ac65a
Sonuga-Barke, E
bc80bf95-6cf9-4c76-a09d-eaaf0b717635
Danckaerts, Marina
e7e7618b-6dd0-4520-bf4e-865597928758
Kovshoff, Hanna
82c321ee-d151-40c5-8dde-281af59f2142
Vrijens, May
f6327e12-080f-47df-b6e5-4d587abc0045
Thompson, Margaret
bfe8522c-b252-4771-8036-744e93357c67
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Hodgkins, Paul
9bfa108c-b193-418d-9f4b-51f09a1ac65a
Sonuga-Barke, E
bc80bf95-6cf9-4c76-a09d-eaaf0b717635
Danckaerts, Marina
e7e7618b-6dd0-4520-bf4e-865597928758

Kovshoff, Hanna, Vrijens, May, Thompson, Margaret, Yardley, Lucy, Hodgkins, Paul, Sonuga-Barke, E and Danckaerts, Marina (2013) What influences clinicians’ decisions about ADHD medication? Initial data from the "influences on prescribing for ADHD questionnaire" (IPAQ). European Child & Adolescent Psychiatry, 22 (9). (doi:10.1007/s00787-013-0393-y). (PMID:23455602)

Record type: Article

Abstract

Despite evidence for its efficacy and effectiveness, the use of medication for the treatment of ADHD remains controversial. Little is known about the factors that influence clinicians’ decisions to use medication for ADHD. Here, we present initial data on the attitudes of prescribing clinicians from the Influences on Prescribing for ADHD Questionnaire (IPAQ)—a new clinician-completed, 40-item scale. The eight IPAQ subscales cover attitudes towards (1) treatment outcome optimisation, (2) the use of rule based over more informal approaches, (3) side effects, (4) symptoms control as the primary goal of treatment, (5) the influence of external pressure on medication-related decisions, (6) the value of taking the child’s views into account, (7) long-term medication use and (8) the value of psychosocial approaches for the treatment of ADHD. Sixty-eight clinicians from Belgium and the UK took part. All subscales had acceptable levels of internal reliability (Chronbach’s alpha = 0.62–0.78). Overall, clinicians reported taking a rule-based approach to prescribing with a focus on treatment optimisation, taking the child’s view into account and valuing psycho-social approaches. They focused on treating broader patterns of impairment, but were wary of the potential side effects and long-term treatment. Psychiatrists scored high on their focus on symptom control and preference for long-term medication use, while paediatricians reported using more rule-based approaches. We identified four distinctive response profiles: (1) pro-psychosocial; (2) medication focused; (3) unsystematic; and (4) response optimizers. Future larger scale studies are required to replicate these profiles and to explore their relationship with prescribing behaviour and treatment outcomes.

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Published date: 2 March 2013
Organisations: Clinical Neuroscience

Identifiers

Local EPrints ID: 349727
URI: https://eprints.soton.ac.uk/id/eprint/349727
ISSN: 1018-8827
PURE UUID: 44cea4c9-9e65-4728-936b-2e793d612947
ORCID for Hanna Kovshoff: ORCID iD orcid.org/0000-0001-6041-0376
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X

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Date deposited: 11 Mar 2013 12:08
Last modified: 17 Sep 2019 01:03

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Contributors

Author: Hanna Kovshoff ORCID iD
Author: May Vrijens
Author: Margaret Thompson
Author: Lucy Yardley ORCID iD
Author: Paul Hodgkins
Author: E Sonuga-Barke
Author: Marina Danckaerts

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