Physicians’ Shared Decision-Making Behaviors in Attention-Deficit/Hyperactivity Disorder Care

In “Physicians’ Shared Decision-Making Behaviors in Attention-Deficit/Hyperactivity Disorder Care” researchers led by Dr. William B. Brinkman sought to describe the amount of shared decision-making (SDM) behavior exhibited during treatment planning encounters for children newly diagnosed with ADHD and to explore relationships between characteristics in the parents/guardians and amount of SDM. Shared decision-making 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.

26 families with children between the ages of 6 and 10 who were newly diagnosed with ADHD who received care from one of 10 pediatricians in 7 practices agreed to participate. They allowed researchers to record doctors’ visits where parents and pediatricians discussed ADHD treatment. These recordings were analyzed using the OPTION scale in order to quantify SDM behavior during the visit.

Overall, low levels of SDM were observed. None of the physicians who were recorded explicitly framed the decision as a choice between behavioral therapy, medication, or both. Instead, these discussions focused solely on medication. More SDM occurred during visits involving families with white vs non-white children, private vs public health insurance, mothers with college education vs high school graduates or less, and parents who did not screen positive for mental illness than those who did. The researchers concluded that interventions may be needed to reduce barriers to SDM, especially with underserved populations.

Publication Information

Brinkman WB, Hartl J, Rawe LM, Sucharew H, Britto MT, Epstein JN. Physicians' Shared Decision-Making Behaviors in Attention-Deficit/Hyperactivity Disorder Care. Archives of Pediatrics & Adolescent Medicine. 2011 Nov;165(11):1013-9.