title: Variations in Physician Attitudes Regarding ADHD and Their Association With Prescribing Practices.
abstract: OBJECTIVE
  The objective of this study was to test whether physicians' attitudes regarding the impact of ADHD on health-related quality of life (HRQL) explain differences in practices for prescribing psychostimulants in children.
  
  
  METHODS
  In a cross-sectional survey, U.S.-based pediatricians and psychiatrists ("physicians") used the Paper-Standard Gamble--a widely used preference-based assessment of HRQL--to rate four vignettes describing ADHD health states of varying severity. Associations between standard gamble scores and questions about prescribing practices were analyzed using ordinal logistic regression.
  
  
  RESULTS
  Surveys were mailed to 291 physicians; 127 (44%) returned complete forms. Lower standard gamble scores were associated with more emphasis on children's ADHD symptoms (p = .03) and less emphasis on parents' concerns about stimulant side effects (p = .03) when prescribing psychostimulants.
  
  
  CONCLUSIONS
  Differences in physician perceptions of the severity of ADHD symptoms and in their emphasis on parental concerns about side effects may help explain variations in ADHD psychostimulant prescription patterns.
authors.affiliation: Tufts University School of Medicine, Boston, MA, USA Tufts Medical Center, Boston, MA, USA rsheldrick@tuftsmedicalcenter.org.
authors.forename: R Christopher
authors.initials: RC
authors.lastname: Sheldrick
authors.affiliation: Tufts University School of Medicine, Boston, MA, USA Tufts Medical Center, Boston, MA, USA.
authors.forename: Laurel K
authors.initials: LK
authors.lastname: Leslie
authors.affiliation: Tufts Medical Center, Boston, MA, USA.
authors.forename: Angie Mae
authors.initials: AM
authors.lastname: Rodday
authors.affiliation: Tufts University School of Medicine, Boston, MA, USA Tufts Medical Center, Boston, MA, USA.
authors.forename: Susan K
authors.initials: SK
authors.lastname: Parsons
authors.affiliation: Tufts Medical Center, Boston, MA, USA.
authors.forename: Tully S
authors.initials: TS
authors.lastname: Saunders
authors.affiliation: Tufts University School of Medicine, Boston, MA, USA Tufts Medical Center, Boston, MA, USA.
authors.forename: John B
authors.initials: JB
authors.lastname: Wong
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D001291:Attitude of Health Personnel; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use*; D010290:Parents; D010465:Perception; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014481:United States
chemical_list: D000697:Central Nervous System Stimulants; D008774:Methylphenidate
keywords: ADHD; quality of life; standard gamble; utility