Shared Decision-Making to Improve Attention-Deficit Hyperactivity Disorder Care
Shared decision-making (SDM) is an approach to health care that involves increased communication between patients and clinicians regarding treatment options in order to facilitate the selection of a specific treatment strategy that is the best fit for each individual patient. The “Shared Decision-Making to Improve Attention-Deficit Hyperactivity Disorder Care” study led by Dr. William Brinkman sought to test an SDM technique aimed at helping parents work with their pediatricians to choose ADHD medication to try for their children.
Seven pediatricians participated in a pre/post open trial of decision aids for use before and during the office visit to discuss diagnosis and develop a treatment plan. Encounters pre- (n = 21, control group) and post-intervention implementation (n = 33, intervention group) were compared. The SDM intervention included a set of cards to be filled out by parents before their meeting with their pediatrician which asked for information regarding treatment goals, preferences, and behavioral treatment history. Parents were also given a booklet with information about ADHD and different treatment options. At their appointment, pediatricians and parents used a set of cards to review attributes of ADHD medication important to consider (i.e. side effects, duration, daily routine, and cost) and decided which medication best met the family’s needs and preferences. The intervention materials from this study are available here.
Parents who received the intervention were more involved in the decision-making process, were more knowledgeable about treatment options, and tended to be less conflicted about these options. Inclusion of the intervention also did not significantly increase visit duration, and physicians were highly satisfied with the intervention.
Publication Information
Brinkman WB, Majcher JH, Poling LM, et al. Shared decision-making to improve attention-deficit hyperactivity disorder care. Patient Education and Counseling. 2013 Oct;93(1):95-101.
