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

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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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Acknowledgments

This work was supported by funding from Shire Development LLC.

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Authors and Affiliations

  1. School of Psychology, University of Southampton, Southampton, UK

    Hanna Kovshoff, Margaret Thompson, Lucy Yardley & Edmund J. S. Sonuga-Barke

  2. Department of Neurosciences, Katholieke Universiteit Leuven, Leuven, Belgium

    May Vrijens & Marina Danckaerts

  3. Global Health Economics and Outcomes Research, Shire Development LLC, Wayne, PA, USA

    Paul Hodgkins

  4. Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium

    Edmund J. S. Sonuga-Barke

Authors
  1. Hanna Kovshoff
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  2. May Vrijens
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  3. Margaret Thompson
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  4. Lucy Yardley
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  5. Paul Hodgkins
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  6. Edmund J. S. Sonuga-Barke
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  7. Marina Danckaerts
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Correspondence to Marina Danckaerts.

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Kovshoff, H., Vrijens, M., Thompson, M. et al. What influences clinicians’ decisions about ADHD medication? Initial data from the Influences on Prescribing for ADHD Questionnaire (IPAQ). Eur Child Adolesc Psychiatry 22, 533–542 (2013). https://doi.org/10.1007/s00787-013-0393-y

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  • DOI: https://doi.org/10.1007/s00787-013-0393-y

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