Decision aid development and its acceptability among adults with attention‐deficit/hyperactivity disorders regarding treatment discontinuation after remission. Issue 4 (14th November 2022)

• Record Type: Journal Article
• Authors: Tsujii, Noa; Okada, Takashi; Usami, Masahide; Kuwabara, Hidenori; Fujita, Junichi; Negoro, Hideki; Iida, Junzo; Aoki, Yumi; Takaesu, Yoshikazu; Saito, Takuya
• Is Part Of: PCN reports. Volume 1:Issue 4(2022)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-11-14
• Subjects: attention‐deficit/hyperactivity disorder -- decision aid -- shared decision making; Psychiatry; Neurosciences; Periodicals; 616.89
• DOI: 10.1002/pcn5.57
• Languages: English
• ISSNs: 1323-1316

Abstract

Abstract: Aim: Current clinical guidelines for attention‐deficit/hyperactivity disorder (ADHD) put shared decision making (SDM) at the center of care. However, there remain challenges in SDM in ADHD management, particularly regarding the decision to continue or discontinue medication after ADHD remission in adult patients. We aimed to develop a decision aid (DA) for adult patients with ADHD regarding the continuation or discontinuation of their ongoing ADHD medications after they have attained remission. Method: We systematically developed a DA according to the International Patient Decision Aid Standard (IPDAS). First, we created a DA prototype using the results of our previous systematic review and meta‐analysis that identified the consequences of continuing and discontinuing ADHD medications. Second, we administered a mixed‐method questionnaire (alpha acceptability testing) to adult patients with ADHD and healthcare providers to improve the DA prototype and develop it into a final version that is acceptable for clinical settings. Results: Our DA consisted of ADHD description, the option to continue or discontinue ADHD medications, the advantages and disadvantages of the consequences, as well as value clarification exercises for each option. Patients ( n = 20) reported that the DA had acceptable language (85%), adequate information (75%), and a well‐balanced presentation (53%). Healthcare providers ( n = 19) provided favorable feedback. The final DA met all six IPDAS requisite criteria. Conclusions: Our results could facilitate the SDM process between patients and healthcare providers on the continuation or discontinuation of ADHD medication following remission. Further studies should verify the effects of using the DA during the SDM process among patients across the age spectrum with ADHD and healthcare providers. Abstract : Current clinical guidelines for attention‐deficit/hyperactivity disorder (ADHD) put shared decision making (SDM) at the center of care. We developed a decision aid (DA) for adult patients with ADHD that contained two options regarding the decision to continue or discontinue current ADHD medication following remission. We successfully developed a DA for adult patients with ADHD who are considering continuation or discontinuation of ADHD medication after symptom remission. Further studies should be performed to verify the effects of using the DA during the SDM process for children, adolescents, and adults with ADHD.