Variations in Physician Attitudes Regarding ADHD and Their Association With Prescribing Practices
R Christopher Sheldrick1, Laurel K Leslie2, Angie Mae Rodday3
1Tufts University School of Medicine, Boston, MA, USA Tufts Medical Center, Boston, MA, USA rsheldrick@tuftsmedicalcenter.org.
Objective:
The objective of this study was to test whether physicians' attitudes regarding the impact of ADHD on health-related quality of life (HRQL) explain differences in practices for prescribing psychostimulants in children.
Method:
In a cross-sectional survey, U.S.-based pediatricians and psychiatrists ("physicians") used the Paper-Standard Gamble--a widely used preference-based assessment of HRQL--to rate four vignettes describing ADHD health states of varying severity. Associations between standard gamble scores and questions about prescribing practices were analyzed using ordinal logistic regression.
Results:
Surveys were mailed to 291 physicians; 127 (44%) returned complete forms. Lower standard gamble scores were associated with more emphasis on children's ADHD symptoms (p = .03) and less emphasis on parents' concerns about stimulant side effects (p = .03) when prescribing psychostimulants.
Conclusion:
Differences in physician perceptions of the severity of ADHD symptoms and in their emphasis on parental concerns about side effects may help explain variations in ADHD psychostimulant prescription patterns.
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