Which factors determine clinicians' policy and attitudes towards medication and parent training for children with Attention-Deficit/Hyperactivity Disorder?

Behavioral parent and teacher training and stimulant medication are recommended interventions for children with attention-deficit/hyperactivity disorder (ADHD). However, not all children with ADHD receive this evidence-based care, and the aim of the current study was to find out why. More specifical...

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Publicado en:European Child & Adolescent Psychiatry Vol. 31; no. 3; pp. 483 - 494
Autores principales: Dekkers, Tycho J., Groenman, Annabeth P., Wessels, Lisa, Kovshoff, Hanna, Hoekstra, Pieter J., van den Hoofdakker, Barbara J.
Formato: research tables/charts Journal Article
Publicado: Springer Nature Mar2022
Acceso en línea:Ver este registro en EBSCOhost
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      place: New York, New York
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      aug:
        au:
          Dekkers, Tycho J.
          Groenman, Annabeth P.
          Wessels, Lisa
          Kovshoff, Hanna
          Hoekstra, Pieter J.
          van den Hoofdakker, Barbara J.
        affil: Department of Child and Adolescent Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
      sug:
        subj:
          Attention Deficit Hyperactivity Disorder Drug Therapy
          Parents Education
          Health Policy
          Practice Guidelines
          Attitude of Health Personnel
          Human
          Clinical Reasoning
          Decision Making, Clinical
          Attitude to Medical Treatment
      ab: Behavioral parent and teacher training and stimulant medication are recommended interventions for children with attention-deficit/hyperactivity disorder (ADHD). However, not all children with ADHD receive this evidence-based care, and the aim of the current study was to find out why. More specifically, we investigated clinicians' policy, guideline use, and attitudes towards medication and parent training when treating children with ADHD, as well as several factors that could affect this. A total of 219 Dutch clinicians (mainly psychologists, psychiatrists and educationalists) completed a survey. Clinicians were likely to recommend medication more often than parent training, and clinicians' policy to recommend medication and parent training was positively associated with their attitudes towards these interventions. Less experienced clinicians and those with a non-medical background reported lower rates of guideline use, whereas clinicians with a medical background reported less positive attitudes towards parent training. Furthermore, a substantial portion of the clinicians based their decision to recommend parent training on their clinical judgement (e.g., prior estimations of efficacy, perceived low abilities/motivation of parents), and many clinicians reported barriers for referral to parent training, such as waiting lists or a lack of skilled staff. To achieve better implementation of evidence-based care for children with ADHD, guidelines should be communicated better towards clinicians. Researchers and policy-makers should further focus on barriers that prevent implementation of parent training, which are suggested by the discrepancy between clinicians' overall positive attitude towards parent training and the relatively low extent to which clinicians actually advise parent training.
      pubtype: Academic Journal
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      ougenre: Article
    language: English
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