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In Their Own Words: Adolescent Views on ADHD and Their Evolving Role Managing Medication

  • William B. Brinkman
    Correspondence
    Address correspondence to William B. Brinkman MD, MEd, 3333 Burnet Avenue, ML 7035, Cincinnati, OH 45229-3039.
    Affiliations
    Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio (Drs Brinkman, Zmitrovich, Visscher, Crosby, Phelan, and Donovan) and SNS Research (Dr Sherman), Cincinnati, Ohio
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  • Susan N. Sherman
    Affiliations
    Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio (Drs Brinkman, Zmitrovich, Visscher, Crosby, Phelan, and Donovan) and SNS Research (Dr Sherman), Cincinnati, Ohio
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  • April R. Zmitrovich
    Affiliations
    Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio (Drs Brinkman, Zmitrovich, Visscher, Crosby, Phelan, and Donovan) and SNS Research (Dr Sherman), Cincinnati, Ohio
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  • Marty O. Visscher
    Affiliations
    Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio (Drs Brinkman, Zmitrovich, Visscher, Crosby, Phelan, and Donovan) and SNS Research (Dr Sherman), Cincinnati, Ohio
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  • Lori E. Crosby
    Affiliations
    Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio (Drs Brinkman, Zmitrovich, Visscher, Crosby, Phelan, and Donovan) and SNS Research (Dr Sherman), Cincinnati, Ohio
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  • Kieran J. Phelan
    Affiliations
    Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio (Drs Brinkman, Zmitrovich, Visscher, Crosby, Phelan, and Donovan) and SNS Research (Dr Sherman), Cincinnati, Ohio
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  • Edward F. Donovan
    Affiliations
    Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio (Drs Brinkman, Zmitrovich, Visscher, Crosby, Phelan, and Donovan) and SNS Research (Dr Sherman), Cincinnati, Ohio
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Published:December 02, 2011DOI:https://doi.org/10.1016/j.acap.2011.10.003

      Abstract

      Objective

      Up to 90% of adolescents with attention deficit hyperactivity disorder (ADHD) remain functionally impaired, yet less than half continue to take medication. The objective of this study was to gain a detailed understanding of how adolescents with ADHD contribute to medication treatment decisions.

      Methods

      Forty-four adolescents with ADHD aged 13 to 18 years old participated in 1 of 7 focus groups. An experienced facilitator used a semi-structured focus group guide to prompt discussion which was audio-recorded and transcribed verbatim. We coded transcripts using an inductive approach. Thematic saturation was reached after the seventh focus group.

      Results

      Adolescents assumed increased responsibility for managing medication as they matured and developed insight into the functional impact of ADHD and medication on their lives. Insights were often formed by contrasting time spent on and off medication. ADHD impacted functioning in the following domains: academics, social interactions and relationships, creativity, and driving skills. Select domains were relevant for some adolescents but not others. Adolescents described different roles that they played in managing medication as well as strategies they used to exert autonomy over medication use. Side effects were common and contributed to negative feelings toward medication. Some adolescents had begun to use medication selectively. Many expressed uncertainty about future use of medication.

      Conclusions

      Adolescents assume an increasing role in managing medication for ADHD. Well-structured and coordinated trials stopping medication and measuring outcomes relevant to adolescents, parents, teachers, doctors, and/or other stakeholders may help ensure a developmentally appropriate transition from family to self-management of ADHD.

      Keywords

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