title: Factors influencing parental decision making about stimulant treatment for attention-deficit/hyperactivity disorder.
abstract: BACKGROUND
  Attention-deficit/hyperactivity disorder (ADHD) is a pediatric psychological condition commonly treated with stimulant medications. Negative media reports and stigmatizing societal attitudes surrounding the use of these medications make it difficult for parents of affected children to accept stimulant treatment, despite it being first line therapy.
  
  
  OBJECTIVE
  The purpose of this study was to identify factors that influence parental decision making regarding stimulant treatment for ADHD.
  
  
  METHODS
  A systematic review of the literature was conducted to identify studies: 1) that employed qualitative methodology, 2) that highlighted treatment decision(s) about stimulant medication, 3) in which the decision(s) were made by the parent of a child with an official ADHD diagnosis, and 4) that examined the factors affecting the decision(s) made. Individual factors influencing parental treatment decision making, and the major themes encompassing these factors, were identified and followed by a thematic analysis.
  
  
  RESULTS
  Eleven studies reporting on the experiences of 335 parents of children with ADHD were included. Four major themes encompassing influences on parents' decisions were derived from the thematic analysis performed: confronting the diagnosis, external influences, apprehension regarding therapy, and experience with the healthcare system.
  
  
  CONCLUSIONS
  The findings of this systematic review reveal that there are multiple factors that influence parents' decisions about stimulant therapy. This information can assist clinicians in enhancing information delivery to parents of children with ADHD, and help reduce parental ambivalence surrounding stimulant medication use. Future work needs to address parental concerns about stimulants, and increase their involvement in shared decision making with clinicians to empower them to make the most appropriate treatment decision for their child.
authors.affiliation: Faculty of Pharmacy, The University of Sydney, New South Wales, Australia.
authors.forename: Rana
authors.initials: R
authors.lastname: Ahmed
authors.forename: Kirsten J
authors.initials: KJ
authors.lastname: McCaffery
authors.forename: Parisa
authors.initials: P
authors.lastname: Aslani
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D002648:Child; D003657:Decision Making; D016527:Drug Costs; D006801:Humans; D010290:Parents / Q000523:psychology*; D010342:Patient Acceptance of Health Care / Q000523:psychology; D012944:Social Support; D013240:Stereotyping
chemical_list: D000697:Central Nervous System Stimulants