title: Preferences for treatment of Attention-Deficit/Hyperactivity Disorder (ADHD): a discrete choice experiment.
abstract: BACKGROUND
  While there is an increasing emphasis on patient empowerment and shared decision-making, subjective values for attributes associated with their treatment still need to be measured and considered. This contribution seeks to define properties of an ideal drug treatment of individuals concerned with Attention-Deficit/Hyperactivity Disorder (ADHD). Because of the lack of information on patient needs in the decision-makers assessment of health services, the individuals' preferences often play a subordinate role at present. Discrete Choice Experiments offer strategies for eliciting subjective values and making them accessible for physicians and other health care professionals.
  
  
  METHODS
  The evidence comes from a Discrete Choice Experiments (DCE) performed in 2007. After reviewing the literature about preferences of ADHS we conducted a qualitative study with four focus groups consisting of five to eleven ADHS-patients each. In order to achieve content validity, we aimed at collecting all relevant factors for an ideal ADHS treatment. In a subsequent quantitative study phase (n = 219), data was collected in an online or paper-pencil self-completed questionnaire. It included sociodemographic data, health status and patients' preferences of therapy characteristics using direct measurement (23 items on a five-point Likert-scale) as well as a Discrete-Choice-Experiment (DCE, six factors in a fold-over design).
  
  
  RESULTS
  Those concerned were capable of clearly defining success criteria and expectations. In the direct assessment and the DCE, respondents attached special significance to the improvement of their social situation and emotional state (relative importance 40%). Another essential factor was the desire for drugs with a long-lasting effect over the day (relative importance 18%). Other criteria, such as flexibility and discretion, were less important to the respondents (6% and 9%, respectively).
  
  
  CONCLUSIONS
  Results point out that ADHD patients and their family members have clear ideas of their needs. This is especially important against the backdrop of present discussions in the healthcare sector on the relevance of patient reported outcomes (PROs) and shared decision-making. The combination of the methods used in this study offer promising strategies to elicit subjective values and making them accessible for health care professionals in a manner that drives health choices.
authors.affiliation: GEB mbH Empirical Consulting (Gesellschaft für Empirische Beratung), 79017 Freiburg, Germany. muehlbacher@hs-nb.de
authors.forename: Axel C
authors.initials: AC
authors.lastname: Mühlbacher
authors.forename: Ina
authors.initials: I
authors.lastname: Rudolph
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Lincke
authors.forename: Matthias
authors.initials: M
authors.lastname: Nübling
mesh_terms: D000293:Adolescent; D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D002755:Choice Behavior; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007223:Infant; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010290:Parents / Q000523:psychology; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires; D055815:Young Adult
references.citation: J Atten Disord. 2009 Mar;12(5):460-8
references.pmid: 18685139
references.citation: Soc Sci Med. 2007 Apr;64(8):1738-53
references.pmid: 17257725
references.citation: Am J Psychiatry. 2007 Jun;164(6):942-8
references.pmid: 17541055
references.citation: Pharmacoeconomics. 2008;26(8):661-77
references.pmid: 18620460
references.citation: Pediatrics. 2005 Jun;115(6):e749-57
references.pmid: 15930203
references.citation: J Health Econ. 2007 Jan;26(1):171-89
references.pmid: 16707175
references.citation: J Child Adolesc Psychopharmacol. 2007 Dec;17(6):813-30
references.pmid: 18315453
references.citation: Eur Child Adolesc Psychiatry. 2004;13 Suppl 1:I7-30
references.pmid: 15322953
references.citation: Annu Rev Med. 2002;53:113-31
references.pmid: 11818466
references.citation: J Am Acad Child Adolesc Psychiatry. 2006 Feb;45(2):192-202
references.pmid: 16429090