Assessment of parents' preferences for the treatment of school-age children with ADHD: a discrete choice experiment

Objectives: Treatment decisions for children with attention-deficit/hyperactivity disorder (ADHD) should include parents' preferences, since parents' acceptance and support are crucial for ensuring treatment adherence and, as a consequence, good clinical outcomes. Discrete choice experiments (DCEs, also known as conjoint experiences) are an important technique for identification and assessment of preferences for different treatment characteristics. In this study, a DCE was performed to analyze and to discuss parents' preferences regarding ADHD treatment for their school-aged children. Methods: This article presents a mixed-method approach; qualitative and quantitative methods were used to ascertain the attributes that might influence a parent's choices for the optimal management of their child with ADHD. Parents of patients with ADHD in Germany completed a self-administered survey. Relevant characteristics of an ideal ADHD treatment were collected by reviewing the literature and by conducting a qualitative study with focus groups. The study involved a subgroup of parents of school-age children aged 6-14 years (n = 121). Attitudes were measured and analyzed using a classic rating scale (5-point Likert format). Preferences were elicited using a DCE; scenarios were analyzed using a random-effects logit model. Results: A total of 121 questionnaires were completed by caregivers (101 mothers, 16 fathers and four others) on behalf of their school-age children (6-14 years, 87% male). Six main attributes were investigated regarding their impact on parent preferences for ADHD treatment. While all were statistically significant in the DCE, improvements in the child's social situation (coefficient: 2.812; odds ratio: 16.64) and emotional state (coefficient: 1.610; odds ratio: 5.00) were rated as the most important by parents. Conclusion: The study provides a valuable insight into parents' preferences regarding treatment for their child with ADHD. If physicians can incorporate this information into their treatment plans for children with ADHD, greater concordance regarding treatment goals, adherence with therapy and, ultimately, clinical outcomes may be achieved.