Evaluating functional outcomes in adolescents with attention-deficit/hyperactivity disorder: development and initial testing of a self-report instrument

Health and Quality of Life Outcomes

M. Haim Erder⁵  Manisha Madhoo⁴  Anna Steenrod²  Robin Pokrzywinski²  Juliana Setyawan³  Asha Hareendran¹ 

[1] Outcomes Research, Evidera, London, UK;Outcomes Research, Evidera, Bethesda, MD, USA;Global Health Economics Outcomes Research, Shire, Wayne, PA, USA;Shire Global Medical Affairs, Shire, Wayne, PA, USA;Global Health Economics and Epidemiology, Shire, Wayne, PA, USA (Affiliation at the time of the study)

关键词: PRO;    Instrument;    Functional outcome;    Development;    Content validity;    Concept elicitation;    Cognitive interview;    Adolescent;    ADHD;   

Others  :  1224704
DOI  :  10.1186/s12955-015-0302-9

 received in 2014-12-12, accepted in 2015-07-14,  发布年份 2015

【 摘 要 】

Background

Engaging adolescents in decisions about their health may enhance their compliance with treatment and result in better health outcomes. Treatment outcomes in attention-deficit/hyperactivity disorder (ADHD) are rarely evaluated from the adolescents’ point of view. There is also concern that adolescents with ADHD may not have insight about the impacts of their disease. This article describes research conducted to understand the experiences of adolescents with ADHD and how the research was used to develop an adolescent self-report instrument.

Methods

This research involved an iterative process to ensure content validity and was conducted in the following stages: concept identification from literature reviews and interviews with teachers and clinicians; concept elicitation interviews with adolescents with ADHD and their caregivers, review of existing instruments; development of a new instrument and cognitive interviews. Experts in instrument development and translation and clinical practitioners in ADHD also participated.

Results

A conceptual framework to measure the impact of ADHD on adolescent functioning identified from concept identification research informed concept elicitation interviews with 60 adolescents with ADHD and their primary caregivers. In the interviews, adolescents discussed difficulties with performing activities in various contexts: school, home, leisure activities and social interactions. Caregivers provided additional insights. The instrument review revealed that none of the existing instruments were suitable to collect data on the elicited concepts; therefore, a new instrument was developed. Revisions were made to the format and content of the instrument (a daily diary) based on feedback received from cognitive testing with 15 adolescents.

Conclusions

Our research helped to obtain a comprehensive understanding of the impacts of ADHD on adolescent functioning, to inform the development of a new instrument for measuring outcomes. Adolescents were able to discuss the impact of ADHD on their lives in concept elicitation interviews and report the impacts of ADHD on a self-report instrument. The new instrument developed to reflect the perspective of adolescents with ADHD can be used to supplement outcome assessments in clinic and research settings. Scientific advocacy for the use of such measures can be valuable to measure outcomes meaningful to adolescents with ADHD and the clinical community.

【 授权许可】

   
2015 Hareendran et al.

【 图 表 】

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