Researchers at The Children's Hospital of Philadelphia Research Institute have developed a groundbreaking new tool to help parents and health care providers treat attention deficit-hyperactivity disorder (ADHD). The tool helps steer families and doctors toward "shared decision-making" (SDM), an approach proven to improve healthcare results in adults, but not yet widely used in pediatric settings.
"Shared decision-making in health care means that doctors and families make decisions together. Doctors contribute their professional knowledge, and families weigh their values and personal experience," explained lead author Alexander Fiks, MD, MSCE, an urban primary care pediatrician at CHOP and a PolicyLab faculty member.
"We chose to focus on ADHD for this study, because it is a relatively common diagnosis with two recommended treatment options — prescription medication and behavioral therapy — that require the family to make decisions about what will work best for them," Dr. Fiks noted.
According to another study published earlier this year, the number of physician outpatient visits in which ADHD was diagnosed in children under age 18 was 10.4 million. Psychostimulants were used in 87 percent of treatments prescribed during those visits.
The CHOP study involved 237 parents of children aged 6-12 who were diagnosed with ADHD within the past 18 months. Using a combination of parent interviews, current research, and input from parent advocates and professional experts, researchers developed a standardized three-part questionnaire to help parents define and prioritize their goals for treatment, attitudes toward medication, and comfort with behavioral therapies.
Pediatric care providers do not usually use SDM to gauge families' preferences and treatment goals for ADHD. The Institute of Medicine and the American Academy of Pediatrics recommend healthcare providers use SDM to help families select the best treatment option for ADHD, and a well-designed questionnaire may help both patient-families and providers to feel more satisfied with their child's ADHD treatment.
The researchers say this is a promising model for more widespread use to aid with treatment decisions for children with ADHD that in the future could be tailored for use with other medical conditions. CHOP is among the first pediatric research institutions to explore how to adapt the philosophy of SDM to a pediatric setting and make it a standard of care.