title: Unmet needs associated with attention-deficit/hyperactivity disorder in eight European countries as reported by caregivers and adolescents: results from qualitative research.
abstract: BACKGROUND
  Attention-deficit/hyperactivity disorder (ADHD) is a neurobehavioral disorder characterized by inattention, impulsivity, and hyperactivity, the levels of which are inappropriately high for an individual's developmental age.
  
  
  OBJECTIVE
  The objective of this study was to explore the unmet needs of children/adolescents with ADHD and their caregivers in eight European countries.
  
  
  METHODS
  Semi-structured interviews with 38 caregivers of children/adolescents (aged 6-17 years) with ADHD and no or less serious comorbidities and 28 adolescents (aged 13-17 years) with ADHD and no or less serious comorbidities were conducted, audio-recorded, transcribed into English, and coded for analysis.
  
  
  RESULTS
  Caregivers reported their own ADHD-related issues, including making personal accommodations, such as limiting activities and spending extra time/effort caring for their child/adolescent, social impacts, and strained relationships. Medication was generally considered helpful; however, most children experience core ADHD symptoms while on medication (reported by 88 % of caregivers and 100 % of adolescents). Adolescents often reported schoolwork difficulties (96 %) and peer issues (75 %), while caregivers reported school issues (84 %) and peer difficulties (79 %). Caregivers reported minimal ADHD education and community support. Caregivers (29 %) and adolescents (54 %) desired medication that better controlled symptoms but had concerns about being oversubdued. Caregivers reported concerns about adverse effects (21 %).
  
  
  CONCLUSIONS
  European caregivers of children/adolescents with ADHD identified multiple unmet needs, which persist despite treatment. Adolescents noted impacts on school and social interactions consistent with caregivers. Future research is needed to quantify the study findings, and, ultimately, ease the impact of ADHD on patients and their caregivers.
authors.affiliation: Global Health Economics, Outcomes Research and Epidemiology, Shire, Wayne, PA, USA.
authors.forename: Vanja
authors.initials: V
authors.lastname: Sikirica
authors.forename: Emuella
authors.initials: E
authors.lastname: Flood
authors.forename: C Noelle
authors.initials: CN
authors.lastname: Dietrich
authors.forename: Javier
authors.initials: J
authors.lastname: Quintero
authors.forename: Val
authors.initials: V
authors.lastname: Harpin
authors.forename: Paul
authors.initials: P
authors.lastname: Hodgkins
authors.forename: Klaus
authors.initials: K
authors.lastname: Skrodzki
authors.forename: Kathleen
authors.initials: K
authors.lastname: Beusterien
authors.forename: M Haim
authors.initials: MH
authors.lastname: Erder
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000523:psychology*; D017028:Caregivers / Q000523:psychology*; D002648:Child; D003430:Cross-Sectional Studies; D005060:Europe; D005260:Female; D006266:Health Education; D006801:Humans; D008297:Male; D010379:Peer Group; D010465:Perception; D036301:Qualitative Research; D012574:Schools