Attention-Deficit/Hyperactivity Disorder: How Much Responsibility Are Pediatricians Taking?

• Published in: Pediatrics (Evanston) 2009-01, Vol.123 (1), p.248-255
• Main Authors: Stein, Ruth E.K, Horwitz, Sarah McCue, Storfer-Isser, Amy, Heneghan, Amy M, Hoagwood, Kimberly Eaton, Kelleher, Kelly J, O'Connor, Karen G, Olson, Lynn
• Format: Article
• Language: English
• Subjects: Adult; Attention Deficit Disorder with Hyperactivity - diagnosis; Attention Deficit Disorder with Hyperactivity - therapy; Attention Deficit Hyperactivity Disorder; Attitude of Health Personnel; Behavior; Biological and medical sciences; Care and treatment; Child behavior; Child behaviour; Children; Data Collection - methods; Diagnosis; Evaluation; Female; General aspects; Health participants; Humans; Male; Medical practices; Medical sciences; Medical treatment; Middle Aged; Pediatricians; Pediatrics; Pediatrics - methods; Pediatrics - standards; Physician's Role - psychology; Public health. Hygiene; Public health. Hygiene-occupational medicine; Referral and Consultation - standards; Regression analysis; Social Responsibility; Surveys
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2007-3198

Attention-deficit/hyperactivity disorder, the most common childhood behavioral condition, is one that pediatricians think they should identify and treat/manage. Our goals were to explore the relationships between pediatricians' self-reports of their practice behaviors concerning usually inquiring about and treating/managing attention-deficit/hyperactivity disorder and (1) attitudes regarding perceived responsibility for attention-deficit/hyperactivity disorder and (2) personal and practice characteristics. We analyzed data from the 59th Periodic Survey of the American Academy of Pediatrics for the 447 respondents who practice exclusively in general pediatrics. Bivariate and logistic regression analyses were used to identify attitudes and personal and practice characteristics associated with usually identifying and treating/managing attention-deficit/hyperactivity disorder. A total of 67% reported that they usually inquire about and 65% reported that they usually treat/manage attention-deficit/hyperactivity disorder. Factors positively associated with usually inquiring about attention-deficit/hyperactivity disorder in adjusted multivariable analyses include perceived high prevalence among current patients, attendance at a lecture/conference on child mental health in the past 2 years, having patients who are assigned or can select a specific pediatrician, practicing in suburban communities, practicing for > or =10 years, and being female. Pediatricians' attitudes about responsibility for identification of attention-deficit/hyperactivity disorder were not associated with usually inquiring about attention-deficit/hyperactivity disorder in either unadjusted or adjusted analyses. Attitudes about treating/managing attention-deficit/hyperactivity disorder were significantly associated with usually treating/managing attention-deficit/hyperactivity disorder in unadjusted and adjusted analyses. Those who perceived that pediatricians should be responsible for treating/managing had almost 12 times the odds of reporting treating/managing attention-deficit/hyperactivity disorder, whereas those who believe physicians should refer had threefold decreased odds of treating/managing. Other physician/practice characteristics significantly associated with the odds of usually treating/managing attention-deficit/hyperactivity disorder include belief that attention-deficit/hyperactivity disorder is very prevalent among current patients, seeing patients who are assigned or can sele