A Latent Class Analysis to Identify Variation in Caregivers’ Preferences for their Child’s Attention-Deficit/Hyperactivity Disorder Treatment: Do Stated Preferences Match Current Treatment?

Xinyi Ng, John F. P. Bridges, Melissa M. Ross, Emily Frosch, Gloria Reeves, Charles E. Cunningham and Susan dosReis ()
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Xinyi Ng: University of Maryland School of Pharmacy
John F. P. Bridges: Johns Hopkins University Bloomberg School of Public Health
Melissa M. Ross: University of Maryland School of Pharmacy
Emily Frosch: Johns Hopkins University School of Medicine
Gloria Reeves: University of Maryland School of Medicine
Charles E. Cunningham: McMaster University
Susan dosReis: University of Maryland School of Pharmacy

The Patient: Patient-Centered Outcomes Research, 2017, vol. 10, issue 2, No 10, 262 pages

Abstract: Abstract Objectives To investigate variation in caregiver preferences for their child’s attention-deficit/hyperactivity disorder (ADHD) care and to determine if their stated preferences align with current care management. Methods Caregivers of a child aged 4–14 years and in care for ADHD were recruited from pediatric outpatient clinics and advocacy groups across the state of Maryland. Participants completed a survey collecting demographics, the child’s treatment, and caregiver preferences—elicited using a best-worst scaling experiment (case 2). Latent class analysis was used to identify distinct preference segments and bivariate analyses were used to compare the association between segment membership with what the child was currently receiving for their ADHD. Results Participants (n = 184) were predominantly White (68%) and the child’s mother (84%). Most children had ADHD for 2 or more years (79%). Caregiver preferences were distinguished by two segments: continuous medication (36%) and minimal medication (64%). The two groups had very different preferences for when medication was administered (p 0.05 for the caregiver behavior training, provider communication, provider specialty, and out-of-pocket costs). One third of the sample did not receive the preferred individualized education program and 42% of the minimal medication group reported using medication 7 days a week all year round. Conclusions Although behavior management training and school accommodations aspects of an ADHD care plan are more important to caregivers than evidence-based medication, fewer families had access to educational accommodations. Further research is needed to clarify how stated preferences for care align with treatments used in actual practice settings.

Date: 2017
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DOI: 10.1007/s40271-016-0202-z

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