Colaneri Natalie, Keim Sarah, Adesman Andrew
Developmental and Behavioral Pediatrics, Cohen Children's Medical Center of New York, New Hyde Park, USA.
Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital, Columbus, USA.
Patient Educ Couns. 2017 Feb;100(2):289-296. doi: 10.1016/j.pec.2016.08.023. Epub 2016 Aug 24.
Recent studies report that adolescents misuse and divert ADHD stimulants. This study evaluates the extent to which physicians educate adolescents with ADHD about stimulant misuse and diversion (M/D).
Child/adolescent psychiatrists (CAP), child neurologists (CN), and developmental-behavioral pediatricians (DBP) in the US completed a questionnaire. Descriptive statistics were performed on the final sample (n=826); multivariate regressions were performed to identify education practice differences.
Only 46% and 44% of physicians educate patients "often" or "very often" on health risks and legal consequences, respectively, of stimulant M/D. CAP are more likely to educate on health and legal consequences than CN, and more likely to educate on legal consequences than DBP. Compared to physicians who prescribe stimulants to 1-10 patients (low prescribers), medium prescribers (11-30 patients) and high prescribers (30+ patients) are more likely to educate about M/D. 60% of physicians counsel patients at least "often" about M/D in a pre-college appointment; 8% have written materials regarding M/D available.
Many physcians currently don't educate adolescent patients with ADHD often enough about M/D. CN and DBP, and low prescribers, are less likely to educate about M/D.
Physicians who prescribe stimulants must educate patients more often to prevent stimulant M/D.
近期研究报告称青少年存在滥用和转借注意力缺陷多动障碍(ADHD)兴奋剂的情况。本研究评估医生就兴奋剂滥用和转借(M/D)问题对患有ADHD的青少年进行教育的程度。
美国的儿童/青少年精神科医生(CAP)、儿童神经科医生(CN)和发育行为儿科医生(DBP)完成了一份调查问卷。对最终样本(n = 826)进行描述性统计;进行多变量回归以确定教育实践差异。
分别只有46%和44%的医生“经常”或“非常经常”就兴奋剂M/D的健康风险和法律后果对患者进行教育。CAP比CN更有可能就健康和法律后果进行教育,且比DBP更有可能就法律后果进行教育。与给1 - 10名患者开具兴奋剂的医生(低处方量医生)相比,中等处方量医生(11 - 30名患者)和高处方量医生(30名以上患者)更有可能就M/D问题进行教育。60%的医生在大学入学前预约时至少“经常”就M/D问题向患者提供咨询;8%有关于M/D的书面材料。
目前许多医生对患有ADHD的青少年患者关于M/D问题的教育不够充分。CN和DBP以及低处方量医生就M/D问题进行教育的可能性较小。
开具兴奋剂的医生必须更频繁地对患者进行教育,以防止兴奋剂M/D情况的发生。