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Perspectives of French adolescents with ADHD and child and adolescent psychiatrists regarding methylphenidate use. Sci Rep 2023; 13:4040. [PMID: 36899043 PMCID: PMC10006242 DOI: 10.1038/s41598-023-30921-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 03/03/2023] [Indexed: 03/12/2023] Open
Abstract
Many studies have demonstrated the short-term efficacy and tolerability of methylphenidate treatment adolescents with attention deficit hyperactivity disorder (ADHD). Qualitative literature on this matter focused on school outcomes, long-term side effects, family conflicts, personality changes and stigmatization. Yet, no qualitative study has crossed the perspectives of child and adolescent psychiatrists (CAPs) prescribing methylphenidate and adolescents with ADHD. This French qualitative study followed the five stages IPSE-Inductive Process to analyze the Structure of lived Experience-approach. Fifteen adolescents with ADHD and 11 CAPs were interviewed. Data collection by purposive sampling continued until data saturation was reached. Data analysis, based on a descriptive and structuring procedure to determine the structure of lived experience characterized by the central axes of experience, produced two axes: (1) The process of methylphenidate prescription, highlighting how this prescription was motivated from the exterior, experienced as passive by the adolescents and required commitment from the CAPs; and (2) the perceived effects of methylphenidate treatment, in three domains: at school, in relationships and in the sense of self. Findings raised both the issues of the epistemic position and social representation of the adolescents about ADHD and methylphenidate within this specific French context, and the self-awareness and perception of the adolescents with ADHD. We conclude that these two issues need to be regularly addressed by the CAPs prescribing methylphenidate to avoid epistemic injustice and prevent the harmful effects of stigmatization.
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Tsujii N, Okada T, Usami M, Kuwabara H, Fujita J, Negoro H, Iida J, Aoki Y, Takaesu Y, Saito T. Decision aid development and its acceptability among adults with attention-deficit/hyperactivity disorders regarding treatment discontinuation after remission. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2022; 1:e57. [PMID: 38868662 PMCID: PMC11114424 DOI: 10.1002/pcn5.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 09/26/2022] [Accepted: 10/20/2022] [Indexed: 06/14/2024]
Abstract
Aim Current clinical guidelines for attention-deficit/hyperactivity disorder (ADHD) put shared decision making (SDM) at the center of care. However, there remain challenges in SDM in ADHD management, particularly regarding the decision to continue or discontinue medication after ADHD remission in adult patients. We aimed to develop a decision aid (DA) for adult patients with ADHD regarding the continuation or discontinuation of their ongoing ADHD medications after they have attained remission. Method We systematically developed a DA according to the International Patient Decision Aid Standard (IPDAS). First, we created a DA prototype using the results of our previous systematic review and meta-analysis that identified the consequences of continuing and discontinuing ADHD medications. Second, we administered a mixed-method questionnaire (alpha acceptability testing) to adult patients with ADHD and healthcare providers to improve the DA prototype and develop it into a final version that is acceptable for clinical settings. Results Our DA consisted of ADHD description, the option to continue or discontinue ADHD medications, the advantages and disadvantages of the consequences, as well as value clarification exercises for each option. Patients (n = 20) reported that the DA had acceptable language (85%), adequate information (75%), and a well-balanced presentation (53%). Healthcare providers (n = 19) provided favorable feedback. The final DA met all six IPDAS requisite criteria. Conclusions Our results could facilitate the SDM process between patients and healthcare providers on the continuation or discontinuation of ADHD medication following remission. Further studies should verify the effects of using the DA during the SDM process among patients across the age spectrum with ADHD and healthcare providers.
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Affiliation(s)
- Noa Tsujii
- Department of Child Mental Health and DevelopmentToyama University HospitalToyamaToyamaJapan
- Department of NeuropsychiatryKindai University Faculty of MedicineOsakasayamaOsakaJapan
| | - Takashi Okada
- Department of Developmental Disorders, National Institute of Mental HealthNational Center of Neurology and PsychiatryKodairaTokyoJapan
| | - Masahide Usami
- Department of Child and Adolescent Psychiatry, Kohnodai HospitalNational Center for Global Health and MedicineIchikawaChibaJapan
| | | | - Junichi Fujita
- Department of Child PsychiatryYokohama City University HospitalYokohamaKanagawaJapan
| | | | - Junzo Iida
- Medical Corporation Nanfukai Manyo ClinicChild Mental Health Care Center KizunaKashiharaNaraJapan
| | - Yumi Aoki
- Graduate School of NursingSt. Luke's International UniversityChuo‐kuTokyoJapan
| | - Yoshikazu Takaesu
- Department of Neuropsychiatry, Graduate School of MedicineUniversity of the RyukyusOkinawaJapan
| | - Takuya Saito
- Department of Child and Adolescent Psychiatry, Faculty of MedicineHokkaido UniversitySapporoHokkaidoJapan
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Zhao X, Coxe SJ, Timmons AC, Frazier SL. Mental Health Information Seeking Online: A Google Trends Analysis of ADHD. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2021; 49:357-373. [PMID: 34553276 DOI: 10.1007/s10488-021-01168-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2021] [Indexed: 01/03/2023]
Abstract
Health information influences consumer decision making to seek, select, and utilize services. Online searching for mental health information is increasingly common, especially by adolescents and parents. We examined historical trends and factors that may influence population-level patterns in information seeking for attention-deficit/hyperactivity disorder (ADHD). We extracted Google Trends data from January 2004 to February 2020. Keywords included "ADHD," "ADHD treatment," "ADHD medication," and "ADHD therapy." We examined trends (systematic change over time) and seasonality (repeating pattern of change) via time-series analyses and graphics. We also used interrupted time-series analyses to examine the impact of celebrity and pharmaceutical events. Queries of "ADHD medication" increase, while queries for "ADHD therapy" remain relatively low despite a positive linear trend. Searches for "ADHD treatment" displayed a downward trend in more recent years. Analyses on seasonality revealed that holiday breaks coincided with a decrease in search interest, while post-break periods illustrated a rise, and the ADHD Awareness Month (October) coincided with a rise of public interest in all four search terms. Celebrity effects were more prominent in earlier years; the "Own It" pharmaceutical campaign may have increased ADHD awareness and the specificity of searches for "ADHD medication." The anonymous, accessible, and low-cost nature of seeking information online makes search engines like Google important sources of mental health information. Changing search patterns in response to seasonal, advocacy, and media events highlight internet-based opportunities for raising awareness and disseminating empirically supported information.
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Affiliation(s)
- Xin Zhao
- Department of Psychology, College of Arts, Sciences, & Education, Florida International University, 11200 SW 8th Street, Miami, USA.
| | - Stefany J Coxe
- Department of Psychology, College of Arts, Sciences, & Education, Florida International University, 11200 SW 8th Street, Miami, USA
| | - Adela C Timmons
- Department of Psychology, College of Arts, Sciences, & Education, Florida International University, 11200 SW 8th Street, Miami, USA
| | - Stacy L Frazier
- Department of Psychology, College of Arts, Sciences, & Education, Florida International University, 11200 SW 8th Street, Miami, USA
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Turan S, Ermiş Ç, Pereira-Sanchez V, Tunctürk M, Pekcanlar AA. ADHD and Drug Holidays: Effects on Anthropometric Changes during Methylpenidate Treatment. PSYCHOPHARMACOLOGY BULLETIN 2021; 51:10-26. [PMID: 34421141 PMCID: PMC8374927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVES The current study evaluated the long-term effects of methylphenidate (MPH) discontinuation on growth parameters in Turkish children and adolescents with attention-deficit/hyperactivity disorder (ADHD). EXPERIMENTAL DESIGN 432 children and adolescents (aged 6-18 years) with ADHD receiving MPH for at least 1 year between March 2012 and January 2019 were included in a retrospective cohort study. We analyzed weight, height, and body mass index (BMI) standard deviation z scores (SDS) of groups that either did (ADHD-C) or did not (ADHD-DC) discontinue MPH. Growth parameters were converted to z scores as normative values for the Turkish population to compare the measurements at baseline and the last follow-up visit by using the paired sample t-test. PRINCIPAL OBSERVATIONS In patients from the ADHD-C group, statistically significant negative correlations were found between age at starting MPH and differences in weight and height SDS between baseline and follow-up. Children had a greater reduction in weight and height compared to adolescents. When we evaluated the differences in pre-and post-treatment growth factors, we found no significant differences between the groups in terms of growth parameters. CONCLUSIONS Our data showed that chronic use of MPH was likely responsible for changes in height and weight parameters.
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Affiliation(s)
- Serkan Turan
- Turan, Uludağ University Child and Adolescent Psychiatry, Bursa, Turkey. Ermiş, Diyarbakır Children's Hospital, Diyarbakır, Turkey. Pereira-Sanchez, NYU Grossman School of Medicine, One Park Avenue, New York, USA. Tunctürk, Istanbul Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatric and Neurological Diseases, Department of Child and Adolescent Psychiatry, Istanbul, Turkey
| | - Çağatay Ermiş
- Turan, Uludağ University Child and Adolescent Psychiatry, Bursa, Turkey. Ermiş, Diyarbakır Children's Hospital, Diyarbakır, Turkey. Pereira-Sanchez, NYU Grossman School of Medicine, One Park Avenue, New York, USA. Tunctürk, Istanbul Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatric and Neurological Diseases, Department of Child and Adolescent Psychiatry, Istanbul, Turkey
| | - Victor Pereira-Sanchez
- Turan, Uludağ University Child and Adolescent Psychiatry, Bursa, Turkey. Ermiş, Diyarbakır Children's Hospital, Diyarbakır, Turkey. Pereira-Sanchez, NYU Grossman School of Medicine, One Park Avenue, New York, USA. Tunctürk, Istanbul Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatric and Neurological Diseases, Department of Child and Adolescent Psychiatry, Istanbul, Turkey
| | - Mustafa Tunctürk
- Turan, Uludağ University Child and Adolescent Psychiatry, Bursa, Turkey. Ermiş, Diyarbakır Children's Hospital, Diyarbakır, Turkey. Pereira-Sanchez, NYU Grossman School of Medicine, One Park Avenue, New York, USA. Tunctürk, Istanbul Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatric and Neurological Diseases, Department of Child and Adolescent Psychiatry, Istanbul, Turkey
| | - Aynur Akay Pekcanlar
- Turan, Uludağ University Child and Adolescent Psychiatry, Bursa, Turkey. Ermiş, Diyarbakır Children's Hospital, Diyarbakır, Turkey. Pereira-Sanchez, NYU Grossman School of Medicine, One Park Avenue, New York, USA. Tunctürk, Istanbul Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatric and Neurological Diseases, Department of Child and Adolescent Psychiatry, Istanbul, Turkey
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Newlove-Delgado T, Blake S, Ford T, Janssens A. Young people with attention deficit hyperactivity disorder in transition from child to adult services: a qualitative study of the experiences of general practitioners in the UK. BMC FAMILY PRACTICE 2019; 20:159. [PMID: 31747903 PMCID: PMC6864948 DOI: 10.1186/s12875-019-1046-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 10/31/2019] [Indexed: 11/10/2022]
Abstract
Background Many young people with Attention Deficit Hyperactivity Disorder (ADHD) have impairing symptoms that persist into adulthood, yet only a minority experience continuity of care into adult life. Despite growing emphasis on the primary care role in ADHD management in NICE ADHD and transition guidance, little is known about GPs’ perspectives, which could hamper efforts to improve outcomes for young people leaving children’s services. This study aimed to understand GPs’ experiences of involvement with this group and explore their views on the roles and responsibilities of primary and secondary care in transition, to inform recommendations for policy and practice. Method Qualitative interview study with GPs across the UK. Semi-structured telephone interviews were carried out with 14 GPs recruited through a linked mapping study, social media, and snowballing; data were analysed using thematic analysis. Results In the absence of a smooth transition from child to adult services, many GPs became involved ‘by default’. GPs reacted by trying to identify suitable specialist services, and were faced with the decision of whether to continue ADHD prescribing. Such decisions were strongly influenced by perceptions that prescribing carried risks, and concerns over responsibility, particularly where specialist services were lacking. Participants described variation in service availability, and some highlighted tensions around how shared care works in practice. Conclusion Implementation of NICE guidance is highly variable, with implications for GPs and patients. Risk and responsibility for primary care ADHD prescribing are central concerns that need to be addressed, as is the inclusion of GPs in a planned transition process.
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Affiliation(s)
| | - Sharon Blake
- University of Exeter Medical School, St Luke's Campus, Exeter, EX1 2LU, United Kingdom
| | - Tamsin Ford
- University of Cambridge, Douglas House, 18b Trumpington Road, Cambridge, CB2 2AH, United Kingdom
| | - Astrid Janssens
- University of Exeter Medical School, St Luke's Campus, Exeter, EX1 2LU, United Kingdom.,Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, DK-5000, Odense C, Denmark
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McCoy KT, Pancione K, Hammonds LS, Costa CB. Management of Attention-Deficit/Hyperactivity Disorder in Primary Care. Nurs Clin North Am 2019; 54:517-532. [PMID: 31703777 DOI: 10.1016/j.cnur.2019.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Management of attention-deficit/hyperactivity disorders require provider skill, rapport, and referral acumen to treat patients across the life span. Incidence and prevalence have increased in the United States and globally. There are innovative models of evidence-informed screening techniques, treatment strategies to help providers work with patients and their families. Diplomatic management of highly charged treatment controversies, drug diversion, and risk factor reduction helps to ethically address this growing public health phenomenon. This article examines risk factors and treatment considerations in the United States for evidence-informed care, with a focus on affordable and readily accessible treatment in primary care settings.
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Affiliation(s)
- Kathleen T McCoy
- Department of Community Mental Health, University of South Alabama, College of Nursing, HAHN 304 / 5721 USA Drive North, Mobile, AL 36688-002, USA
| | - Kirsten Pancione
- Department of Community Mental Health, University of South Alabama, College of Nursing, HAHN 304 / 5721 USA Drive North, Mobile, AL 36688-002, USA
| | - Linda Sue Hammonds
- Department of Community Mental Health, University of South Alabama, College of Nursing, HAHN 304 / 5721 USA Drive North, Mobile, AL 36688-002, USA
| | - Christine B Costa
- California State University Long Beach, School of Nursing, 1250 Bellflower Boulevard, MS 0301, Long Beach, CA 90804, USA.
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Ibrahim K, Randolph G, Doran O, Donyai P. The Construction and Validation of Child, Adolescent and Parental Decision Aids for Considering Methylphenidate Drug Holidays in ADHD. PHARMACY 2018; 6:E122. [PMID: 30477233 PMCID: PMC6306803 DOI: 10.3390/pharmacy6040122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 11/05/2018] [Accepted: 11/18/2018] [Indexed: 11/16/2022] Open
Abstract
Guidelines recommend encouraging young people with attention deficit hyperactivity disorder (ADHD) who are taking medication long-term, to discuss their preferences for stopping or changing their treatment, including a discussion about 'drug holidays', with their doctor. Yet, to date, no written information has been available to empower children and adolescents with ADHD and their parents to make informed decisions about drug holidays. The aim of this study was to design and develop a suite of decision aids to help families decide if they want to take a drug holiday from methylphenidate. The material was designed with reference to the literature and in consultation with a secondary-care specialist, and validated with two panels composed of specialists and parents using content validity questionnaires and interviews; before being finished and branded by a design service. Three decision aids were produced, with parental and adolescent versions composed of a booklet and a pull-out form for self-completion, and the child version being a booklet for reading and self-completion. Existing research calls for suitable written materials to feasibly increase the uptake of practitioner-initiated planned drug holidays from methylphenidate. We envisage these materials will open up the space to discuss drug holidays in ADHD during annual reviews, in line with UK government guidelines.
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Affiliation(s)
- Kinda Ibrahim
- NIHR CLAHRC Wessex, University Hospital Southampton NHS Foundation Trust, Faculty of Medicine, University of Southampton, Southampton SOA6 6YD, UK.
| | - Gina Randolph
- Reading School of Pharmacy, University of Reading, P.O. Box 226, Whiteknights, Reading RG6 6AP, UK.
| | - Olivia Doran
- Reading School of Pharmacy, University of Reading, P.O. Box 226, Whiteknights, Reading RG6 6AP, UK.
| | - Parastou Donyai
- Reading School of Pharmacy, University of Reading, P.O. Box 226, Whiteknights, Reading RG6 6AP, UK.
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