Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-23T12:43:05.306Z Has data issue: false hasContentIssue false
  • English
  • Français

Attitudes and practices in the management of ADHD among healthcare professionals who responded to a European survey

Published online by Cambridge University Press:  18 September 2013

M. Fitzgerald  and
F. McNicholas
M. Fitzgerald
Affiliation:
Department of Psychiatry, Trinity College Dublin, College Green, Dublin, Ireland
F. McNicholas*
Affiliation:
Department of Child Psychiatry, Our Lady's Hospital for Sick Children, Dublin and Lucena Clinic, Rathgar, Dublin, Ireland
*
*Address for correspondence: Professor M. Fitzgerald, Department of Psychiatry, Trinity College Dublin, College Green, Dublin 2, Ireland. (Email [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

To examine attitudes and practices in the management of attention-deficit/hyperactivity disorder (ADHD) among health professionals across seven European countries.

Methods

The web-based survey was developed by an international steering committee of ADHD experts and consisted of 64 multiple-choice questions relating to ADHD, covering the following topics: attitudes, diagnosis, referral, treatment and improving care. Health professionals working with ADHD were identified using a medical marketing database (Medical Marketing Service Inc., IL, USA) and invited via email to participate in the survey. No incentive was offered for participation and the survey was only available in English.

Results

Over 22 000 emails and postal invitations were sent. One hundred and thirty-four (0.6%) health professionals completed the survey. Results highlighted significant differences by profession and country. In general, ADHD is considered a clinically important and valid disorder (n = 111, 84%), with biological underpinnings (n = 82, 62%), continuing into adulthood (n = 123, 93%) and responsive to treatment. Respondents from France were less likely to be convinced about biological validity (n = 4, 27%) and those from Italy and France were more likely to be concerned about the risk of underdiagnosis (n = 9, 64% and n = 9, 60%, respectively). Psychologists were the specialty who most frequently reported not believing in the diagnostic validity of ADHD (n = 4, 19%). One-third (n = 25, 35%) of respondents recommended medical tests before prescribing medication, with differences emerging by country despite the lack of support for such routine assessments in the guidelines.

Conclusions

Despite the very low response rate, intriguing country- and profession-specific differences emerged in this study and warrant further exploration.

Keywords

Attention-deficit/hyperactivity disorderattitude of healthcare personnelguidelineshealthcare surveysphysician's practice patterns
Type
Short Report
Information
Irish Journal of Psychological Medicine , Volume 31 , Issue 1 , March 2014 , pp. 31 - 37
Copyright
Copyright © College of Psychiatrists of Ireland 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders. DSM-IV-TR. Fourth Edition (Text Revision). American Psychiatric Association: Arlington, Virginia, USA.Google Scholar
Atkinson, M, Hollis, C (2010). NICE guideline: attention deficit hyperactivity disorder. Archives of Disease in Childhood. Education and Practice Edition 95, 24–27.Google Scholar
Beirne, M, McNamara, N, O'Keeffe, G, McNicholas, F (2012). Survey examining the views of Irish adult psychiatry consultants and senior registrars regarding ADHD. Poster presented at the College of Psychiatry of Ireland Winter Meeting, Dublin.Google Scholar
CADDRA (2011). Canadian ADHD Practice Guidelines, 3rd edn. (http://www.caddra.ca/cms4/pdfs/caddraGuidelines2011.pdf). Accessed 12 March 2013.Google Scholar
Eysenbach, G, Wyatt, J (2002). Using the internet for surveys and health research. Journal of Medical Internet Research 4(2), e13.Google Scholar
Hamilton, R, Rosenthal, E, Hulpke-Wette, M, Graham, JG, Sergeant, J, for the European Network of Hyperkinetic and the Association of European Paediatric Cardiology (2011). Cardiovascular considerations of attention deficit hyperactivity disorder medications: a report of the European Network on Hyperactivity Disorders work group, European Attention Deficit Hyperactivity Disorder Guidelines Group on attention deficit hyperactivity disorder drug safety meeting. Cardiology in the Young 22, 63–70.Google Scholar
Jensen, PS, Arnold, LE, Swanson, JM, Vitiello, B, Abikoff, HB, Greenhill, LL, Hechtman, L, Hinshaw, SP, Pelham, WE, Wells, KC, Conners, CK, Elliott, GR, Epstein, JN, Hoza, B, March, JS, Molina, BS, Newcorn, JH, Severe, JB, Wigal, T, Gibbons, RD, Hur, K (2007). 3-year follow-up of the NIMH MTA study. Journal of the American Academy of Child and Adolescent Psychiatry 46, 989–1002.Google Scholar
Jones, R, Pitt, N (1999). Health surveys in the workplace: comparison of postal, e-mail and World Wide Web methods. Occupational Medicine (London) 49, 556–558.Google Scholar
Kooij, SJ, Bejerot, S, Blackwell, A, Caci, H, Casas-Brugue, M, Carpentier, PJ, Edvinsson, D, Fayyad, J, Foeken, K, Fitzgerald, M, Gaillac, V, Ginsberg, Y, Henry, C, Krause, J, Lensing, MB, Manor, I, Niederhofer, H, Nunes-Filipe, C, Ohlmeier, MD, Oswald, P, Pallanti, S, Pehlivanidis, A, Ramos-Quiroga, JA, Rastam, M, Ryffel-Rawak, D, Stes, S, Asherson, P (2010). European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD. BMC Psychiatry 10, 67.Google Scholar
Mises, R, Quemada, N, Botbol, M, Burzsteijn, C, Garrabe, J, Golse, B, Jeammet, P, Plantade, A, Portelli, C, Thevenot, JP (2002). French classification for child and adolescent mental disorders. Psychopathology 35, 176–180.Google Scholar
Molina, BS, Hinshaw, SP, Swanson, JM, Arnold, LE, Vitiello, B, Jensen, PS, Epstein, JN, Hoza, B, Hechtman, L, Abikoff, HB, Elliott, GR, Greenhill, LL, Newcorn, JH, Wells, KC, Wigal, T, Gibbons, RD, Hur, K, Houck, PR, MTA Cooperative Group (2009). The MTA at 8 years: prospective follow-up of children treated for combined-type ADHD in a multisite study. Journal of the American Academy of Child and Adolescent Psychiatry 48, 484–500.Google Scholar
MTA (Multimodal Treatment Study of Children with ADHD) Cooperative Group (1999). A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. Archives of General Psychiatry 56, 1073–1086.CrossRefGoogle Scholar
Neurotransmitter.net (2013). Psychiatric rating scales for attention deficit hyperactivity disorder (ADHD). (http://neurotransmitter.net/adhdscales.html). Accessed 12 March 2013.Google Scholar
O'Keeffe, N, McNicholas, F (2011). Paediatricians’ views on their role in the assessment and management of ADHD and autism. Irish Medical Journal 104, 282–284.Google Scholar
Pliszka, S (2007). Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. Journal of the American Academy of Child and Adolescent Psychiatry 46, 894–921.Google Scholar
Preuss, U, Ralston, SJ, Baldursson, G, Falissard, B, Lorenzo, MJ, Rodrigues Pereira, R, Vlasveld, L, Coghill, D, ADORE Study Group (2006). Study design, baseline patient characteristics and intervention in a cross-cultural framework: results from the ADORE study. European Child and Adolescent Psychiatry 15, Suppl. 1. I4–I14.Google Scholar
Shaw, M, Hodgkins, P, Caci, H, Young, S, Kahle, J, Woods, AG, Arnold, LE (2012). A systematic review and analysis of long-term outcomes in attention deficit hyperactivity disorder: effects of treatment and non-treatment. BMC Medicine 10, 99.Google Scholar
US FDA (2010). Drug safety information for healthcare professionals. http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/DrugSafetyInformationforHeathcareProfessionals/default.htm. Accessed 23 November 2011.Google Scholar
Vallée, M (2011). Resisting American Psychiatry: French Opposition to DSM-III, Biological Reductionism, and the Pharmaceutical Ethos. Sociology of Diagnosis. Emerald Group Publishing Limited: Bingley, UK, pp 85–110.Google Scholar
World Health Organization (2010). International statistical classification of diseases and related health problems, 10th revision. (http://www.who.int/classifications/icd/en/). Accessed 25 January 2012.Google Scholar
Wyatt, JC (2000). When to use web-based surveys. Journal of the American Medical Informatics Association 7, 426–429.CrossRefGoogle ScholarPubMed