Unmet care needs of children with ADHD


Autoři: Richard Vijverberg aff001;  Robert Ferdinand aff001;  Aartjan Beekman aff003;  Berno van Meijel aff002
Působiště autorů: GGZ Delfland, Department of Child and Adolescent Psychiatry, Delft, The Netherlands aff001;  Inholland University of Applied Sciences, Amsterdam, the Netherlands aff002;  Amsterdam UMC, VU Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands aff003;  Parnassia Psychiatric Institute, The Hague, the Netherlands aff004
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: 10.1371/journal.pone.0228049

Souhrn

Background

Non-compliance to, or drop-out from treatment for childhood ADHD, result in suboptimal outcome. Non-compliance and drop-out may be due to mismatches between patients' care needs and treatments provided. This study investigated unmet care needs in ADHD patients. Unmet needs were assessed in two different treatment settings (general outpatient setting versus youth-ACT). Youth-ACT treatment is an intensive outreach-oriented treatment for patients with severe psychiatric and psychosocial problems. Comparison of a general outpatient sample with a youth-ACT sample enabled us to assess the influence of severity of psychiatric and psychosocial problems on perceived care needs.

Methods

Self-reported unmet care needs were assessed among 105 ADHD patients between 6 and 17 years of age in a general outpatient (n = 52) and a youth-ACT setting (n = 53).

Results

ADHD patients most frequently reported unmet needs regarding mental health problems, information on diagnosis/treatment, and future prospects. Outpatients differed from youth-ACT patients with respect to 30% of the unmet care needs that were investigated. Outpatients perceived more unmet needs regarding information on diagnosis/treatment (p = 0.014). Youth-ACT patients perceived more unmet needs concerning medication side effects (p = 0.038), quality and/or quantity of food (p = 0.016), self-care abilities (p = 0.016), regular/suitable school or other daytime activities (p = 0.013), making and/or keeping friends (p = 0.049), and future prospects (p = 0.045).

Conclusions

Focusing treatment of ADHD patients on unmet needs may reduce non-compliance and drop-out. In clinical practice, systematic assessment of unmet care needs in all ADHD patients may be warranted, e.g. using the CANSAS questionnaire during the screening/intake phase.

Klíčová slova:

ADHD – Adolescents – Drug therapy – Mental health and psychiatry – Neuropsychological testing – Outpatients – Psychological and psychosocial issues – Schools


Zdroje

1. Polanczyk G, Salum G, Sugaya L, Caye A., Rohde L. Annual research review: a meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. J Child Psychol Psychiatry. 2015;56(3):345–65. doi: 10.1111/jcpp.12381 25649325

2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). Arlington: American Psychiatric Association Publishing; 2013

3. Garner A, O'Connor B, Narad M, Tamm L, Simon J, Epstein J. The relationship between ADHD-symptom dimensions, clinical correlates, and functional impairments. J Dev Behav Pediatr. 2013; 34(7):469–77. doi: 10.1097/DBP.0b013e3182a39890 24042078

4. Spencer T, Biederman J, Mick E. Attention-deficit/hyperactivity disorder: diagnosis, lifespan, comorbidities, and neurobiology. J Pediatr Psychol. 2007;32(6):631–42. doi: 10.1093/jpepsy/jsm005 17556405

5. Harpin V. The effect of ADHD on the life of an individual, their family and community from preschool to adult life. Arch Dis Child. 2005;90(Supplement 1):i2–i7. doi: 10.1136/adc.2004.059006 15665153

6. World Health Organization. International statistical classification of diseases and related health problems, 10th Version. Geneva: WHO Press. 2016. https://icd.who.int/browse10/Content/statichml/ICD10Volume2_en_2016.pdf. Accessed 10 Feb 2019.

7. GGZ Nederland. Factsheet specialistische jeugd-GGZ. 2013. https://www.ggznederland.nl/uploads/publication/Factsheet%20specialistische%20jeugd-ggz.pdf. Accessed 21 Jan 2019.

8. Nictiz. International classification of functioning, disability and health. Nictiz expertise centrum e-health. 2018. https://www.nictiz.nl/standaarden/icf. Accessed 15 Feb 2019.

9. Rajeh A, Amanullah S, Shivakumar K, Cole J. Interventions in ADHD: A comparative review of stimulant medications and behavioral therapies. Asian J Psychiatr. 2017;25:131–5. doi: 10.1016/j.ajp.2016.09.005 28262134

10. Watson S, Richels C, Michalek A. Psychosocial treatments for ADHD: a systematic appraisal of the evidence. J Atten Disord. 2015;19(1):3–10. doi: 10.1177/1087054712447857 22647286

11. Rots-de Vries C, van Goor I, Stronks K, Garretsen H. Evaluation of an assertive outreach intervention for problem families: intervention methods and early outcomes. Scand J Caring Sci. 2011;25(2):211–9. doi: 10.1111/j.1471-6712.2010.00811.x 20626696

12. Russell A, Ford T, Russell G. The relationship between financial difficulty and childhood symptoms of attention deficit/hyperactivity disorder: a UK longitudinal cohort study. Soc Psychiatry Psychiatr Epidemiol. 2018;53(1):33–44. doi: 10.1007/s00127-017-1453-2 29124294

13. Vijverberg R, Ferdinand R, Beekman A, van Meijel B. Factors associated with treatment intensification in child and adolescent psychiatry. BMC Psychiatry. 2018;18(291):1–10. doi: 10.1186/s12888-018-1874-9 30200911

14. Cuffe S, Moore C, McKeown R (2009) ADHD and health services utilization in the National Health Interview Survey. J Atten Disord 12(4):330–40. doi: 10.1177/1087054708323248 19095891

15. de Haan A, Boon A, de Jong J, Hoeve M, Vermeieren R. A meta-analytic review on treatment dropout in child and adolescent outpatient mental health care. Clin Psychol Rev. 2013;33(5):698–711. doi: 10.1016/j.cpr.2013.04.005 23742782

16. Gearing R, Schwalbe C, Dweck P, Berkowitz P. Investigating adherence promoters in evidence-based mental health interventions with children and adolescents. Community Ment Health J. 2012;48(1):63–70. doi: 10.1007/s10597-011-9394-9 21394473

17. Barkley R, Fischer M, Smallish L, Fletcher K. The persistence of attention-deficit/hyperactivity disorder into young adulthood as a function of reporting source and definition of disorder. J Abnorm Psychol. 2002;111(2):279–89. https://doi.org/10.1037.0021-843X.111.2.279 12003449

18. de Haan A, Boon A, de Jong J, Vermeiren R. A review of mental health treatment dropout by ethnic minority youth. Transcult Psychiatry. 2018;55(1):3–30. doi: 10.1177/1363461517731702 29035137

19. Ford T, MacDiarmid F, Russell A, Racey D, Goodman R. The predictors of persistent DSM-IV disorders in 3-years follow-ups of the Britsh child and adolescent mental health surveys 1999 and 2004. Psychol Med. 2017;47(6):1126–37. doi: 10.1017/S0033291716003214 27995813

20. Leslie L, Wolraich M. ADHD service use patterns in youth. J Pediatr Psychol. 2007;32(6):695–710. doi: 10.1093/jpepsy/jsm023 17556401

21. Stein B, Klein G, Greenhouse J, Kogan J. Treatment of attention-deficit hyperactivity disorder: patterns of evolving care during the first treatment episode. Psychiatr Serv. 2012;63(2):120–9. doi: 10.1176/appi.ps.201000532 22302328

22. Wilens T, McBurnett K, Bukstein O, McGough J, Greenhill L, Lerner M, et al. Multisite controlled study of OROS methylphenidate in the treatment of adolescents with attention-deficit/hyperactivity disorder. Arch Pediatr Adolesc Med. 2006;160(1):82–90. doi: 10.1001/archpedi.160.1.82 16389216

23. Corkum P, Bessey M, McGonnell M, Dorbeck A. Barriers to evidence-based treatment for children with attention-deficit/hyperactivity disorder. Atten Defic Hyperact Disord. 2015;7(1):49–74. doi: 10.1007/s12402-014-0152-z 25055885

24. Hancock G, Orrell M. Introduction: defining need. In: CANE—Camberwell Assessment of Need for elderly: a needs assessment for older mental health service users. London: Gaskell; 2004.

25. Schaefer M, Rawlinson A, Wagoner S, Shapiro S, Kavookjian J, Gray W. Adherence to attention-deficit/hyperactivity disorder medication during the transition to college. J Adolesc health. 2017;60(6):706–13. doi: 10.1016/j.jadohealth.2016.12.011 28162841

26. Sikirica V, Flood E, Dietrich C, Quintero J, Harpin V, Hodgkins P, et al. Unmet needs associated with attention-deficit/hyperactivity disorder in eight European countries as reported by caregivers and adolescents: results from qualitative research. PATIENT. 2014;8(3):269–81. doi: 10.1007/s40271-014-0083-y 25344102

27. Eklund H, Findon J, Cadman T, Hayward H, Murphy D, Asherson P, et al. Needs of adolescents and young adults with neurodevelopmental disorders: comparison of young people and parents perspectives. J Autism Dev Disord. 2018;48(1):83–91. doi: 10.1007/s10803-017-3295-x 28894999

28. Kendall J, Leo M, Perrin N, Hatton D. Service needs of families with children with ADHD. J Fam Nurs. 2005;11(3):264–88. doi: 10.1177/1074840705278629 16287828

29. Appleton S, Pugh K. Planning mental health services for young adults, improving transition: a resource for health and social care commissioners. London: National mental health development unit; 2011.

30. Lasalvia A, Boggian I, Bonetto C, Saggioro V, Piccione G, Zanoni C, et al. Multiple perspectives on mental health outcome: Needs of care and service satisfaction assessed by staff, patients and family members. Soc Psychiatry Psychiatr Epidemiol. 2012;47(7):1035–45. doi: 10.1007/s00127-011-0418-0 21850522

31. Emilsson M, Gustafsson P, Öhnström G, Marteinsdottir I. Beliefs regarding medication and side effects influence treatment adherence in adolescents with attention deficit hyperactivity disorder. Eur Child Adolesc Psychiatry. 2017;26(5)559–71. doi: 10.1007/s00787-016-0919-1 27848023

32. Üstün T. Using the international classification of functioning, disease and health in attention-deficit/hyperactivity disorder: separating the disease form its epiphenomena. Ambul Pediatr. 2007;7(1):132–9. doi: 10.1016/j.ambp.2006.05.004 17261492

33. Roeg D, van de Lindt S, Lohuis G, van Doorn L. Bemoeizorg van A tot Z. Assertieve en outreachende zorg. Amsterdam: SPW; 2015.

34. Deault L. A systematic review of parenting in relation to the development of comorbidities and functional impairments in children with attention-deficit/hyperactivity disorder (ADHD). Child Psychiatry Hum Dev. 2010;41(2):168–92. doi: 10.1007/s10578-009-0159-4 19768532

35. Jans T, Jacob C. ADHD in families. In: Surman C, editor. ADHD in adults: a practical guide to evaluation and management. New York: Springer; 2013. p 169–90.

36. Reflectum. Bibliotheek vragenlijsten NVPP/LVE. Deventer: Reflectum; 2013.

37. Sheehan D, Sheehan K, Shytle R, Janavs J, Bannon Y, Rogers J, et al. Reliability and validity of the mini international neuropsychiatric interview for children and adolescents (MINI-KID). J Clin Psychiatry. 2010;71(3):313–26. doi: 10.4088/JCP.09m05305whi 20331933

38. Phelan M, Slade M, Thornicroft G, Dunn G, Holloway F, Wykes T. The Camberwell Assessment of Need: the validity and reliability of an instrument to assess the needs of people with severe mental illness. Br J Psychiatry. 1995;167(5):589–95. doi: 10.1192/bjp.167.5.589 8564313

39. Andresen R, Caputi P, Oades L. Interrater reliability of the Camberwell Assessment of Need Short Appraisal Schedule. Aust N Z J Psychiatry. 2000;34(5):856–61. doi: 10.1080/j.1440-1614.2000.00814.x 11037374

40. Trauer T, Tobias G, Slade M. Development and evaluation of a patient-rated version of the Camberwell Assessment of Need Short Appraisal Schedule (CANSAS-P). Community Ment Health J. 2008;44(2):113–24. doi: 10.1007/s10597-007-9101-z 17701455

41. Dobryzynska E, Rymanszewska J, Biecek P, Kiejna A. Do mental health outpatient services meet users' needs? Trail to identify factors associated with higher needs for care. Community Ment Health J. 2016;52(4), 472–8. doi: 10.1007/s10597-015-9923-z 26387519

42. Campbell I. Chi-squared and Fisher-Irwin test of two-by-two tables with small sample recommendations. Stat Med. 2007;26(19):3661–75. doi: 10.1002/sim.2832 17315184

43. Mistler L, Drake R. Shared decision-making in antipsychotic management. J Psychiatr Pract. 2008;14(6):333–44. doi: 10.1097/01.pra.0000341889.97759.54 19057236

44. Stobbe J, Wierdsma A, Kok R, Kroon H, Depla M, Roosenschoon B, et al. Lack of motivation for treatment with greater care needs and psychosocial problems. Aging Ment Health. 2013;17(8):1052–8. doi: 10.1080/13607863.2013.807422 23767934

45. Bordin E. The generalizability of the psychoanalytic concept of the working alliance. Psychother Theor Res Pract. 1979;16(3):252–60. https://doi.org/10.1037/h0085885

46. Munson M, Cole A, Jaccard J, Kranke D, Farkas K, Frese F. An engagement intervention for young adults with serious mental health conditions. J Behav Health Serv Res. 2016;43(4):542–63. doi: 10.1007/s11414-014-9424-9 24989700

47. Garcia J, Weisz J. When youth mental health care stops: therapeutic relationships problems and other reasons for ending youth outpatient treatment. J Consult Clin Psychol. 2002;70(2):439–43. https://doi.org/10.1037/0022-006X.70.2.439 11952203

48. Verhulst F. De ontwikkeling van het kind. Assen: Amsterdam; 2001.

49. Patel R, Pate P, Shah K, Kaur M, Mansuri Z, Makani R. Is cannabis use associated with the worst outcomes in attention deficit hyperactivity disorder adolescents? Cureus. 2018;10(1):1–10. doi: 10.7759/cureus.2033 29535906

50. Elkins I, Saunders G, Malone S, Keyes M, McGue M, Lacono W. Associations between childhood ADHD, gender, and adolescent alcohol and marijuana involvement: a causally informative design. Drug Alcohol Depend. 2018;184:33–41. doi: 10.1016/j.drugalcdep.2017.11.011 29402677

51. Lee S, Humphreys K, Flory K, Lui R, Glass K. Prospective association of childhood attention-deficit/hyperactivity disorder (ADHD) and substance use and abuse/dependence: a meta-analytic review. Clin Psychol Rev. 2011;31(3):328–41 doi: 10.1016/j.cpr.2011.01.006 21382538

52. Clever S, Ford D, Rubenstein L, Ros K, Meredith L, Sherbourne C, et al. Primary care patients' involvement in decision-making is associated with improvement in depression. Med Care. 2006;44(5):398–405 doi: 10.1097/01.mlr.0000208117.15531.da 16641657

53. Westermann G, Verheij F, Winkens B, Verhulst F, Van Oort F. Structured shared decision-making using dialogue and visualization: a randomised controlled trail. Patient Educ Couns. 2013;90(1):74–81. doi: 10.1016/j.pec.2012.09.014 23107362

54. Agency for Healthcare Research and Quality. Attention Deficit Hyperactivity Disorder: diagnosis and treatment in children and adolescents. Rockville: Agency for Healthcare Research and Quality Comparative Effectiveness Reviews; 2018.

55. Roy A, Hechtman L, Arnold L, Swanson J, Molina B, Sibley M, et al. Childhood predictors of adult functional outcomes in the multimodal treatment study of attention-deficit/hyperactivity disorder (MTA). J Am Acad Child Adolesc Psychiatry. 2017;56(8):687–95. doi: 10.1016/j.jaac.2017.05.020 28735698

56. Belcher J. Attention deficit hyperactivity disorder in offenders and the need for early intervention. Int J Offender Ther Comp Criminol. 2014;58(1):27–40. doi: 10.1177/0306624X12465583 23222217

57. Hartup W. The company they keep: friendships and their developmental significance. Child Dev. 1996;67(1):1–13. https://doi.org/10.1111/j.1467-8624.1996/tb01714.x 8605821

58. Ronk M, Hund A., Landau S. Assessment of social competence of boys with attention-deficit/hyperactivity disorder: problematic peer entry, host responses, and evaluations. J Abnor Child Psychol. 2011;39(6):829–40. doi: 10.1007/s10802-011-9497-3 21468667


Článek vyšel v časopise

PLOS One


2020 Číslo 1