title: Beliefs regarding medication and side effects influence treatment adherence in adolescents with attention deficit hyperactivity disorder.
abstract: Adherence to attention deficit hyperactivity disorder (ADHD) treatment is important because, when untreated, it may have serious consequences with lifelong effects. In the case of adolescents on long-term medicine prescription, more knowledge is needed regarding adherence and factors influencing adherence, which was the purpose of this study. Adolescents (n = 101) on ADHD medication ≥6 months were administrated questionnaires at a monitoring appointment: Medication Adherence Report Scale (MARS), beliefs about medicines (BMQ) and the Brief Illness Perception Questionnaire (B-IPQ). Adherence was high, the mean value was 88% of the maximum MARS score, and correlated positively with the "BMQ-necessity-concerns differential" but negatively with "BMQ-concerns" and "BMQ-side effects". Adolescents with more belief in the necessity of the medication, less concerns and less experience of side effects tended to be more adherent to medication prescription ("intentional non-adherence"), while "unintentional non-adherence" (forgetfulness) was associated with how much they perceived that their ADHD affected their lives. In a multiple regression model, the variance of MARS total (R2= 0.21) and "intentional non-adherence" (R2= 0.24) was explained by the "BMQ-necessity-concern differential" and "BMQ-experienced side effects". The variance of "unintentional non-adherence" (R2= 0.12) was explained by the "BMQ-necessity-concern differential" and "B-IPQ-consequences of ADHD". In conclusion, adolescents on long-term medication reported good adherence, mainly influenced by more beliefs in the necessity versus concerns of the medications, less experienced side effects and more perceived consequences of ADHD. BMQ could be useful to identify risks of low adherence, which should be counteracted by partially gender-specific interventions.
authors.affiliation: Department of Health Science, Section of Nursing Graduate Level, University Wes, 461 86, Trollhättan, Sweden.|Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience, Linköping University, 581 85, Linköping, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Emilsson
authors.affiliation: Department of Clinical and Experimental Medicine and Department of Child and Adolescent Psychiatry, Center for Social and Affective Neuroscience, Linköping University, 581 85, Linköping, Sweden. Per.a.gustafsson@liu.se.
authors.forename: Per A
authors.initials: PA
authors.lastname: Gustafsson
authors.affiliation: Department of Clinical and Experimental Medicine and Department of Child and Adolescent Psychiatry, Center for Social and Affective Neuroscience, Linköping University, 581 85, Linköping, Sweden.
authors.forename: Gisela
authors.initials: G
authors.lastname: Öhnström
authors.affiliation: Department of Clinical and Experimental Medicine, Center for Social and Affective Neuroscience, Linköping University, 581 85, Linköping, Sweden.
authors.forename: Ina
authors.initials: I
authors.lastname: Marteinsdottir
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D018765:Dopamine Uptake Inhibitors / Q000627:therapeutic use*; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008774:Methylphenidate / Q000627:therapeutic use*; D010465:Perception; D011795:Surveys and Questionnaires; D013548:Sweden; D016903:Drug Monitoring
chemical_list: D000697:Central Nervous System Stimulants; D018765:Dopamine Uptake Inhibitors; D008774:Methylphenidate
keywords: ADHD; Adolescents; Medication beliefs; Perception; Treatment adherence