title: Caregiver Treatment Preferences for Children with a New Versus Existing Attention-Deficit/Hyperactivity Disorder Diagnosis.
abstract: OBJECTIVE
  Parental experiences with managing their child's attention-deficit/hyperactivity disorder (ADHD) can influence priorities for treatment. This study aimed to identify the ADHD management options caregivers most prefer and to determine if preferences differ by time since initial ADHD diagnosis.
  
  
  METHODS
  Primary caregivers (n = 184) of a child aged 4-14 years old in care for ADHD were recruited from January 2013 through March 2015 from community-based pediatric and mental health clinics and family support organizations across the state of Maryland. Participants completed a survey that included child/family demographics, child clinical treatment, and a Best-Worst Scaling (BWS) experiment to elicit ADHD management preferences. The BWS comprised 18 ADHD management profiles showing seven treatment attributes, where the best and worst attribute levels were selected from each profile. A conditional logit model using effect-coded variables was used to estimate preference weights stratified by time since ADHD diagnosis.
  
  
  RESULTS
  Participants were primarily the mother (84%) and had a college or postgraduate education (76%) with 75% of the children on stimulant medications. One-on-one caregiver behavior training, medication use seven days a week, therapy in a clinic, and an individualized education program were most preferred for managing ADHD. Aside from caregiver training and monthly out-of-pocket costs, caregivers of children diagnosed with ADHD for less than two years prioritized medication use lower than other care management attributes and caregivers of children diagnosed with ADHD for two or more years preferred school accommodations, medication, and provider specialty.
  
  
  CONCLUSIONS
  Preferences for ADHD treatment differ based on the duration of the child's ADHD. Acknowledging that preferences change over the course of care could facilitate patient/family-centered care planning across a range of resources and a multidisciplinary team of professionals.
authors.affiliation: 1 Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy , Baltimore, Maryland.
authors.forename: Susan
authors.initials: S
authors.lastname: dosReis
authors.affiliation: 1 Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy , Baltimore, Maryland.
authors.forename: Alex
authors.initials: A
authors.lastname: Park
authors.affiliation: 1 Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy , Baltimore, Maryland.
authors.forename: Xinyi
authors.initials: X
authors.lastname: Ng
authors.affiliation: 2 Department of Psychiatry, Johns Hopkins University School of Medicine , Baltimore, Maryland.
authors.forename: Emily
authors.initials: E
authors.lastname: Frosch
authors.affiliation: 3 Department of Psychiatry, University of Maryland School of Medicine , Baltimore, Maryland.
authors.forename: Gloria
authors.initials: G
authors.lastname: Reeves
authors.affiliation: 4 Department of Psychiatry and Behavioral Neurosciences, McMaster University , Hamilton, Ontario Canada .
authors.forename: Charles
authors.initials: C
authors.lastname: Cunningham
authors.affiliation: 5 Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health , Baltimore, Maryland.
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Janssen
authors.affiliation: 5 Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health , Baltimore, Maryland.
authors.forename: John F P
authors.initials: JFP
authors.lastname: Bridges
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D017028:Caregivers; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D002648:Child; D003430:Cross-Sectional Studies; D004519:Education, Special; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009035:Mothers; D010290:Parents; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
chemical_list: D000697:Central Nervous System Stimulants
keywords: best worst scaling; caregivers; patient-centered care; stated preferences