ARTICLE Physicians’ Shared Decision-Making Behaviors in Attention-Deficit/Hyperactivity Disorder Care William B. Brinkman, MD, MEd; Jessica Hartl, BA; Lauren M. Rawe, BA; Heidi Sucharew, PhD; Maria T. Britto, MD, MPH; Jeffery N. Epstein, PhD Objectives: To describe the amount of shared decision- ing from 0 (no parental involvement) to 100 (maximal making (SDM) behavior exhibited during treatment- parental involvement). planning encounters for children newly diagnosed as hav- Results: Treatmentdecisionsfocusedoninitiationofmedi- ing attention-deficit/hyperactivity disorder and to explore cation treatment. The mean (SD) total OPTION score was relationships between participant characteristics and the 28.5(11.7).MoreSDMwasobservedduringencountersin- amount of SDM. volving families with white vs nonwhite children (adjusted mean difference score, 14.9; 95% confidence interval [CI], Design: Prospective cohort study. 10.2-19.6;P.001),privatevspublichealthinsurancecov- erage (adjusted mean difference score, 15.1; 11.2-19.0; Setting: Seven community-based primary care pediat- P.001), mothers with at least some college education vs ric practices in the Cincinnati, Ohio; northern Ken- highschoolgraduateorless(adjustedmeandifferencescore, tucky; and southeast Indiana regions from October 5, 12.3; 7.2-17.4; P.001), and parents who did not screen 2009, through August 9, 2010. positiveforseriousmentalillnessvsthosewhodid(adjusted mean difference score, 15.0; 11.9-18.1; P.001). Participants: Ten pediatricians and 26 families with a 6- to 10-year-old child newly diagnosed as having atten- Conclusions: Low levels of SDM were observed. Ex-
JAMA Pediatrics – American Medical Association
Published: Nov 1, 2011
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