Skip to main content

Advertisement

SpringerLink
Log in

Communication About ADHD and Its Treatment During Pediatric Asthma Visits

  • Original Paper
  • Published:
Community Mental Health Journal Aims and scope Submit manuscript

Abstract

The objectives of the study were to examine provider-family communication about attention deficit disorder during pediatric asthma visits. Children with asthma, aged 8 through 16 and their parents were recruited at five pediatric practices. All medical visits were audio-taped. There were 296 asthmatic children enrolled into the study and 67 of them also had attention deficit hyperactivity disorder (ADHD). ADHD communication elements suggested by national guidelines were discussed infrequently. Providers were more likely to discuss, educate, and ask one or more questions about ADHD medications if the visit was non-asthma related. Providers included child input into the ADHD treatment regimen during 3 % of visits and they included parent input during 4.5 % of visits. Only one child and three parents asked questions about ADHD. Providers may neglect essential aspects of good ADHD management and communication in children who have ADHD plus another chronic condition such as asthma. Providers should set appropriate treatment expectations, establish target symptoms, and encourage children and parents to ask questions so mutual decision-making can occur.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • American Academy of Pediatrics (AAP). (2001) Subcommittee on attention-deficit/hyperactivity disorder, committee on quality improvement. Clinical practice guideline: Treatment of the school-aged child with attention-deficit/hyperactivity disorder. Pediatrics, 108(4), 1033–1044.

    Google Scholar 

  • American Academy of Pediatrics (AAP). (2011) ADHD: Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Subcommittee on attention-deficit/hyperactivity disorder, steering committee on quality improvement and management improvement. Pediatrics, 128(5), 1007–1022.

    Google Scholar 

  • Berwick, D. (2002). A user’s manual for the IOM’s “Quality Chasm” report. Health Affairs, 21, 80–90.

    Article  PubMed  Google Scholar 

  • Blackman, J. A., & Gurka, M. J. (2007). Developmental and behavioral comorbidities of asthma in children. Journal of Developmental and Behavioral Pediatrics, 20, 92–99.

    Article  Google Scholar 

  • Brinkman, W. B., Hartl, J., Poling, L. M., et al. (2013). Shared decision-making to improve attention-deficit hyperactivity disorder care. Patient Education and Counseling, 93(1), 95–101.

    Article  PubMed  Google Scholar 

  • Brinkman, W. B., Hartl, J., Rawe, L. M., et al. (2011). Physicians’ shared decision-making behaviors in attention-deficit/hyperactivity disorder care. Archives of Pediatrics and Adolescent Medicine, 165, 1013–1019.

    Article  PubMed Central  PubMed  Google Scholar 

  • Brown, T. N., Ueno, K., Smith, C. L., Austin, N. S., & Bickman, L. (2007). Communication patterns in medical encounters for the treatment of child psychosocial problems: Does pediatrician-parent concordance matter? Health Communication, 21(3), 247–256.

    Article  PubMed  Google Scholar 

  • Charles, G., Gafni, A., & Whelan, T. (1997). Shared decision-making in the medical encounter: What does it mean? (or it takes at least two to tango). Social Science and Medicine, 44, 681–692.

    Article  CAS  PubMed  Google Scholar 

  • Chen, C. Y., Gerhard, T., & Winterstein, A. G. (2009). Determinants of initial pharmacological treatment for youths with attention-deficit/hyperactivity disorder. Journal of Child Adolescent Psychopharmacology, 19(2), 187–195.

    Article  CAS  PubMed  Google Scholar 

  • Creer, T. L., & Gustafson, K. E. (1989). Psychological problem associated with drug therapy in childhood asthma. American Journal of Pediatrics, 115, 850–855.

    Article  CAS  Google Scholar 

  • Daly, J., Biederman, J., Bostic, J., Maraganore, A., Lelon, E., Jellinek, M., et al. (1996). The relationship between childhood asthma and attention deficit hyperactivity disorder. Journal of Attention Disorder, 1, 31–40.

    Article  Google Scholar 

  • Fiks, A. G., Hughes, C. C., Gafen, A., Guevara, J. P., & Barg, F. K. (2011). Contrasting parents’ and pediatricians’ perspectives on shared decision-making in ADHD. Pediatrics, 127(1), 188–196.

    Article  Google Scholar 

  • Finding, R. L., Connor, D. F., Wigal, T., Eagan, C., & Onofrey, M. N. (2009). A linguistic analysis of in-office dialogue among psychiatrists, parents, and child and adolescent patients with ADHD. Journal of Attention Disorder, 13(1), 78–86.

    Article  Google Scholar 

  • Fowler, M. G., Davenport, M. G., & Garg, R. (1992). School functioning of US children with asthma. Pediatrics, 90(6), 939–944.

    CAS  PubMed  Google Scholar 

  • Harpaz-Rotem, I., & Rosenheck, R. A. (2006). Prescribing practices of psychiatrists and primary care physicians caring for mental illness. Child: Care, Health and Development, 32(2), 225–237.

    CAS  Google Scholar 

  • Honeycutt, C., Sleath, B., Bush, P. J., Campbell, W., & Tudor, G. (2005). Physician use of a participatory decision-making style with children with ADHD and their parents. Patient Education and Counseling, 57, 327–332.

    Article  PubMed  Google Scholar 

  • Institute of Medicine (IOM). (2001). Committee on Quality of Health Care in America. Crossing the quality chasm: A new health system of the 21st century. Washington, DC: National Academy Press.

  • Larson, K., Russ, S. A., Kahn, R. S., et al. (2007). Patterns of comorbidity, functioning, and service use for US children with ADHD, Pediatrics. doi:10.1542/peds,2010-0165.

  • Lindgren, S., Loskshin, B., Stromquist, A., Weinberger, M., Nassif, E., McCubbin, M., et al. (1992). Does asthma or treatment with theophylline limit children’s academic performance? New England Journal of Medicine, 32(13), 926–930.

    Article  Google Scholar 

  • Mattingly, G., Surman, C. B., Mao, A. R., Eagan, C. A., Onofrey, M., Lerner, M. (2011). Improving communication in ADHD care: results from in-office linguistic research. CNS Spectrums [Epub ahead of print].

  • Nall, M., Corbett, M., McLoughlin, J., Petrosko, J., Darcia, D., & Karibo, J. (1992). Impact of short-term oral steroid use upon children’s school achievement and behavior. Annals of Allergy, 69(3), 218–220.

    CAS  PubMed  Google Scholar 

  • Power, T. J., Mautone, J. A., Manz, P. H., Frye, L., & Blum, N. J. (2008). Managing attention-deficit/hyperactivity disorder in primary care: a systematic analysis roles and challenges. Pediatrics, 121(1), e65–e72.

    Article  PubMed  Google Scholar 

  • Rey, J. M., & Sawyer, M. G. (2003). Are psychostimulant drugs being used appropriately to treat child and adolescent disorders? British Journal of Psychiatry, 182, 284–286.

    Article  PubMed  Google Scholar 

  • Scherwitz, L., Hennrikus, D., Yusim, S., Lester, J., & Carlos Vallbon, C. (1985). Physician communication to patients regarding medications. Patient Education and Counseling, 7(2), 121–136.

    Article  CAS  PubMed  Google Scholar 

  • Sleath, B. L., Carpenter, D. M., Sayner, R., Ayala, G. X., Williams, D., Davis, S., et al. (2011). Child and caregiver involvement and shared decision-making during asthma pediatric visits. Journal of Asthma, 48(10), 1022–1031.

    Article  PubMed Central  PubMed  Google Scholar 

  • Sleath, B., Roter, D., Chewning, B., & Svarstad, B. (1999). Asking questions about medication: analysis of physician-patient interactions and physician perception. Medical Care, 37, 1169–1173.

    Article  CAS  PubMed  Google Scholar 

  • Sleath, B., Tulsky, J. A., Peck, B. M., & Thorpe, J. (2007). Provider-patient communication about antidepressants among veterans with mental health conditions. The American Journal of Geriatric Pharmacotherapy, 5, 9–17.

    Article  PubMed  Google Scholar 

  • Winterstein, A. G., Gerhard, T., Shuster, J., Zito, J., Johnson, M., Liu, H., et al. (2008). Utilization of pharmacologic treatment in youths with attention deficit/hyperactivity disorder in medicaid database. The Annals of Pharmacotherapy, 42, 24–31.

    Article  PubMed  Google Scholar 

  • Young, H. N., Bell, R. A., Epstein, R. M., Feldman, M. D., & Kravitz, R. L. (2006). Types of information physicians provide when prescribing antidepressants. Journal of General Internal Medicine, 21, 1172–1177.

    Article  PubMed Central  PubMed  Google Scholar 

  • Yuskel, H., Sogut, A., & Yilmaz, O. (2008). Attention deficit and hyperactivity symptoms in children with asthma. Journal of Asthma, 45(7), 545–547.

    Article  Google Scholar 

Download references

Acknowledgments

This project was funded by the National Heart Lung and Blood Institute (Grant No HL069837). The project was also supported in part by grant UL 1RR025747 from the National Center of Research Resources, NIH.

Conflict of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Author information

Authors and Affiliations

  1. Division of Pharmaceutical Outcomes and Policy, University of North Carolina at Chapel Hill Eshelman School of Pharmacy, 2214 Kerr Hall, CB#7573, Chapel Hill, NC, 27599, USA

    Betsy Sleath, Delesha M. Carpenter, Catherine Slota & Robyn Sayner

  2. Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, CB # 7590, Chapel Hill, NC, 27599-7590, USA

    Betsy Sleath, Sandra H. Sulzer & Catherine Slota

  3. Department of Pharmacy Administration, Marshall University School of Pharmacy, Huntington Campus, 1 John Marshall Drive, Huntington, WV, 25755, USA

    Christopher Gillette

  4. Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA

    Stephanie Davis

  5. Section of Pediatric Pulmonology and Allergy, Riley Hospital for Children, 705 Riley Hospital Dr. ROC 4270, Indianapolis, IN, 46202, USA

    Stephanie Davis

  6. Olson Huff Center, Mission Children’s Hospital, St. Joseph Campus, Asheville, NC, 28804, USA

    Adrian Sandler

Authors
  1. Betsy Sleath
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sandra H. Sulzer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Delesha M. Carpenter
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Catherine Slota
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Christopher Gillette
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Robyn Sayner
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Stephanie Davis
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Adrian Sandler
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Betsy Sleath.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sleath, B., Sulzer, S.H., Carpenter, D.M. et al. Communication About ADHD and Its Treatment During Pediatric Asthma Visits. Community Ment Health J 50, 185–192 (2014). https://doi.org/10.1007/s10597-013-9678-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10597-013-9678-3

Keywords

Search

Navigation