Personalized ADHD Medication Experiments to Inform Decisions About Continued Medication Use: An Open-Label Trial

To pilot test personalized stimulant medication experiments among children 11 to 15 years old with ADHD who questioned maintaining their current medication regimen.

Open-label trial involving 30 children (63.3% male, 86.7% white) and their parents. Experiments involved tracking personally meaningful measures daily for 2 weeks on their current regimen and 2 to 4 weeks after making a change. Validated outcome measures included the Decisional Conflict Scale (DCS) and the Decision-Making Involvement Scale (DMIS).

Participants selected 1 of 5 experiments: 1) try different dose or medication (50.0%); 2) start taking medicine on non-school days (20.0%); 3) stop taking medicine on non-school days (16.7%); 4) discontinue medicine (6.7%); and 5) no change (6.7%). Parents and children completed 92.8% (standard deviation [SD] = 7.5) of daily tracking questions. Following the experiment, 46.7% chose to continue the regimen tried during the experiment, 23.3% returned to their previous regimen, and 30.0% returned to their primary care provider to discuss other options. Participants felt less conflicted about treatment pre- to post-experiment, with parent mean (SD) pre DCS score = 15.9 (13.7)→post = 9.3 (10.0), P = .01; child pre DCS score = 26.3 (11.6)→post = 22.5 (13.1), P = .12. The mean (SD) DMIS subscale score for parents seeking information/opinions from their child increased from pre-to-post-experiment based on reports from children (pre = 2.6 (0.8), post = 2.9 (0.7), P = .03) but not parents (pre = 2.6 (0.7), post = 2.6 (0.7), P = .48). Most parents (83.3%) and children (76.7%) rated the medication experiment as helpful to extremely helpful.

Personalized medication experiments show promise to support the transition from family- to self-management of ADHD.