MSCE, The Children's Hospital of Philadelphia, 3535 Market Street, Room 1546, Philadelphia, PA 19104.
Pediatrics. 2013 Oct;132(4):692-702. doi: 10.1542/peds.2013-0152. Epub 2013 Sep 2.
To describe the association between parents' attention-deficit/hyperactivity disorder (ADHD) treatment preferences and goals and treatment initiation.
Parents/guardians of children aged 6 to 12 years diagnosed with ADHD in the past 18 months and not currently receiving combined treatment (both medication and behavior therapy [BT]) were recruited from 8 primary care sites and an ADHD treatment center. Parents completed the ADHD Preference and Goal Instrument, a validated measure, and reported treatment receipt at 6 months. Logistic regression was used to analyze the association of baseline preferences and goals with treatment initiation. Using linear regression, we compared the change in preferences and goals over 6 months for children who initiated treatment versus others.
The study included 148 parents/guardians. Baseline medication and BT preference were associated with treatment initiation (odds ratio [OR]: 2.6 [95% confidence interval (CI):1.2-5.5] and 2.2 [95% CI: 1.0-5.1], respectively). The goal of academic achievement was associated with medication initiation (OR: 2.1 [95% CI: 1.3-3.4]) and the goal of behavioral compliance with initiation of BT (OR: 1.6 [95% CI: 1.1-2.4]). At 6 months, parents whose children initiated medication or BT compared with others had decreased academic and behavioral goals, suggesting their goals were attained. However, only those initiating BT had diminished interpersonal relationship goals.
Parental treatment preferences were associated with treatment initiation, and those with distinct goals selected different treatments. Results support the formal measurement of preferences and goals in practice as prioritized in recent national guidelines for ADHD management.
描述父母的注意力缺陷/多动障碍（ADHD）治疗偏好和目标与治疗开始之间的关系。
从 8 个初级保健场所和一个 ADHD 治疗中心招募了过去 18 个月内被诊断为 ADHD 的 6 至 12 岁儿童的父母/监护人，且他们目前未接受联合治疗（药物治疗和行为疗法[BT]）。父母填写 ADHD 偏好和目标量表（一种经过验证的测量工具），并报告 6 个月时的治疗情况。采用逻辑回归分析基线偏好和目标与治疗开始的关系。使用线性回归比较治疗开始和未开始的儿童在 6 个月时偏好和目标的变化。
该研究纳入了 148 位父母/监护人。基线时药物和 BT 偏好与治疗开始相关（比值比[OR]：2.6 [95%置信区间（CI）：1.2-5.5]和 2.2 [95% CI：1.0-5.1]）。学业成就目标与药物治疗开始相关（OR：2.1 [95% CI：1.3-3.4]），行为依从目标与 BT 治疗开始相关（OR：1.6 [95% CI：1.1-2.4]）。在 6 个月时，与未开始治疗的儿童相比，开始药物或 BT 治疗的儿童的学业和行为目标降低，表明他们的目标已实现。但是，只有开始 BT 治疗的儿童的人际关系目标下降。
父母的治疗偏好与治疗开始相关，有明确目标的父母选择了不同的治疗方法。这些结果支持在实践中正式测量偏好和目标，这也是最近 ADHD 管理国家指南中优先考虑的事项。
