Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Nov 14;1(4):e57.
doi: 10.1002/pcn5.57. eCollection 2022 Dec.

Decision aid development and its acceptability among adults with attention-deficit/hyperactivity disorders regarding treatment discontinuation after remission

Noa Tsujii  1   2 , Takashi Okada  3 , Masahide Usami  4 , Hidenori Kuwabara  5 , Junichi Fujita  6 , Hideki Negoro  7 , Junzo Iida  8 , Yumi Aoki  9 , Yoshikazu Takaesu  10 , Takuya Saito  11
Affiliations

Decision aid development and its acceptability among adults with attention-deficit/hyperactivity disorders regarding treatment discontinuation after remission

Noa Tsujii et al. PCN Rep. .

Abstract

Aim: Current clinical guidelines for attention-deficit/hyperactivity disorder (ADHD) put shared decision making (SDM) at the center of care. However, there remain challenges in SDM in ADHD management, particularly regarding the decision to continue or discontinue medication after ADHD remission in adult patients. We aimed to develop a decision aid (DA) for adult patients with ADHD regarding the continuation or discontinuation of their ongoing ADHD medications after they have attained remission.

Method: We systematically developed a DA according to the International Patient Decision Aid Standard (IPDAS). First, we created a DA prototype using the results of our previous systematic review and meta-analysis that identified the consequences of continuing and discontinuing ADHD medications. Second, we administered a mixed-method questionnaire (alpha acceptability testing) to adult patients with ADHD and healthcare providers to improve the DA prototype and develop it into a final version that is acceptable for clinical settings.

Results: Our DA consisted of ADHD description, the option to continue or discontinue ADHD medications, the advantages and disadvantages of the consequences, as well as value clarification exercises for each option. Patients (n = 20) reported that the DA had acceptable language (85%), adequate information (75%), and a well-balanced presentation (53%). Healthcare providers (n = 19) provided favorable feedback. The final DA met all six IPDAS requisite criteria.

Conclusions: Our results could facilitate the SDM process between patients and healthcare providers on the continuation or discontinuation of ADHD medication following remission. Further studies should verify the effects of using the DA during the SDM process among patients across the age spectrum with ADHD and healthcare providers.

Keywords: attention‐deficit/hyperactivity disorder; decision aid; shared decision making.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
Process of developing a DA for adult patients with ADHD that contained two options for continuation or discontinuation of ADHD medication treatment after remission, following the approach of Coulter et al. ADHD, attention‐deficit/hyperactivity disorder; DA, decision aid.
FIGURE 2
FIGURE 2
Pictorial diagram of outcomes of the DA for continuing or discontinuing ADHD medication. ADHD, attention‐deficit/hyperactivity disorder; DA, decision aid.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. American Psychiatric Association . (2013). Diagnostic and statistical manual of mental disorders fifth edition (DSM‐5) Washington, DC: American Psychiatric Pub Incorporated.
    1. Coghill DR, Banaschewski T, Soutullo C, Cottingham MG, Zuddas A. Systematic review of quality of life and functional outcomes in randomized placebo‐controlled studies of medications for attention‐deficit/hyperactivity disorder. Eur Child Adolesc Psychiatry. 2017;26:1283–307. - PMC - PubMed
    1. Faraone SV, Asherson P, Banaschewski T, Biederman J, Buitelaar JK, Ramos‐Quiroga JA, et al. Attention‐deficit/hyperactivity disorder. Nat Rev Dis Primers. 2015;1:15020. - PubMed
    1. Faraone SV, Banaschewski T, Coghill D, Zheng Y, Biederman J, Bellgrove MA, et al. The World Federation of ADHD International Consensus Statement: 208 evidence‐based conclusions about the disorder. Neurosci Biobehav Rev. 2021;128:789–818. - PMC - PubMed
    1. Cortese S. Pharmacologic treatment of attention deficit‐hyperactivity disorder. N Engl J Med. 2020;383:1050–56. - PubMed