Promoting productive interactions between parents and physicians in the treatment of children with attention-deficit/hyperactivity disorder

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a common neurobehavioral condition that impairs functioning throughout childhood and adolescence. Evidence-based guidelines for the treatment of ADHD recommend recognizing ADHD as a chronic condition. The chronic care model for child health emphasizes the need for productive interactions between an informed, activated family and a prepared, proactive practice team. Key parent–physician interactions in the treatment of a child with ADHD include: family education, treatment goal setting, treatment plan formation, cardiovascular screening, medication titration and ongoing monitoring and treatment plan revision. Most care for children/adolescents with ADHD is provided in community-based primary care settings where there are significant barriers to delivering high-quality care to children with chronic conditions. This article reviews recommended physician–parent interactions, examines current practice patterns and identifies facilitators and barriers to the implementation of recommended practices for ADHD care.

Keywords::

• attention-deficit/hyperactivity disorder
• chronic care model
• participatory/shared decision-making
• physician–patient/parent communication
• primary care
• quality improvement

Financial & competing interests disclosure

William Brinkman is supported by a Mentored Patient-Oriented Research Career Development Award from the National Institute of Mental Health (K23 MH083027). Jeffery Epstein is supported by a Mid-Career Investigator Award in Patient-Oriented Research from the National Institute of Mental Health (K24 MH064478). Jeffery Epstein also receives research funding from Eli Lilly & Company. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.