Lensing Michael B, Zeiner Pål, Sandvik Leiv, Opjordsmoen Stein
Women and Children's Division, Oslo University Hospital, Ullevål, Building 31 B, 2nd Floor, Nydalen, P.O. Box 4956, 0424, Oslo, Norway,
Atten Defic Hyperact Disord. 2013 Dec;5(4):369-76. doi: 10.1007/s12402-013-0116-8. Epub 2013 Aug 22.
This study investigated the agreement on treatment for attention-deficit/hyperactivity disorder (ADHD) between adults with ADHD and the primary care physicians responsible for their treatment. Adults with ADHD and the primary care physicians responsible for their ADHD treatment completed a survey. The κ-statistic assessed physician-patient agreement on ADHD treatment variables. The eligible sample consisted of 274 patients with confirmed current or previous psychopharmacological treatment for ADHD and the physicians responsible for their treatment. We received 159 questionnaires (58.0 %) with sufficient information from both sources. There were no significant differences between participants and nonparticipants (N = 115) on ADHD sample characteristics. Participants' mean age was 37.6 years, and 75 (47.2 %) were females. There was high agreement for current pharmacological treatment for ADHD, current and last ADHD drug prescription, treatment for substance use, and misuse of stimulant medication. Agreement for nonpharmacological treatment for ADHD and treatment termination because of the side effects was low. A minority of participants from both sources reported misuse of stimulant medication. There was a moderate correlation between the physicians' clinical judgment and patients' self-report on current functioning. The study showed that primary care physicians and their patients agreed on the pharmacological but not the nonpharmacological, treatments given. They also agreed on patients' current functioning. Physicians and patients reported low levels of misuse of stimulant medication. The results show that pharmacological treatment for adults with ADHD can be safely undertaken by primary care physicians.
本研究调查了患有注意力缺陷多动障碍（ADHD）的成年人与负责其治疗的初级保健医生在ADHD治疗方面的一致性。患有ADHD的成年人以及负责其ADHD治疗的初级保健医生完成了一项调查。κ统计量评估了医生与患者在ADHD治疗变量上的一致性。符合条件的样本包括274名确诊目前或既往接受过ADHD心理药物治疗的患者以及负责其治疗的医生。我们从双方获得了159份（58.0%）包含足够信息的问卷。参与者与未参与者（N = 115）在ADHD样本特征方面无显著差异。参与者的平均年龄为37.6岁，其中75名（47.2%）为女性。在ADHD的当前药物治疗、当前及最后一次ADHD药物处方、物质使用治疗以及刺激性药物滥用方面存在高度一致性。在ADHD的非药物治疗以及因副作用而终止治疗方面的一致性较低。双方来源的少数参与者报告了刺激性药物的滥用情况。医生的临床判断与患者对当前功能的自我报告之间存在中度相关性。该研究表明，初级保健医生与其患者在给予的药物治疗方面意见一致，但在非药物治疗方面意见不一致。他们在患者当前功能方面也意见一致。医生和患者报告的刺激性药物滥用水平较低。结果表明，初级保健医生可以安全地对患有ADHD的成年人进行药物治疗。
