Trial Outcomes & Findings for Refining the Shared Decision Making Process Survey in ADHD Medication Decisions (NCT NCT05048186)

NCT ID: NCT05048186

Last Updated: 2024-11-21

Results Overview

The Shared Decision Making Process scale is a short patient-reported survey that measures the amount of shared decision making that occurs in an interaction. Scores range from 0-4 where higher values indicate a better shared decision making process occurred.

Recruitment status

COMPLETED

Target enrollment

512 participants

Primary outcome timeframe

baseline survey (reflecting on the last 24 months)

Results posted on

2024-11-21

Participant Flow

Eligible participants were recruited through a national sampling firm, but the sample itself was not a national probability sample. The survey was administered between February 2021 and March 2021. A subset of participants were invited to complete a brief follow-up survey to examine short term test-retest reliability.

Eligible participants were caregivers who self-identified as having at least one child between the ages of 5 and 13 years old with ADHD and who had talked with a health care provider about starting, stopping, or changing an ADHD medicine in the last 2 years.

Participant milestones

Participant milestones
Measure
Decision Aid Arm
Participants in this arm will review educational material from the ADHD Decision Aid developed by the Cincinnati Children's Hospital Medical Center. Attention Deficit Hyperactivity Disorder Treatment Decision Aid: The parent pre-visit cards from the Cincinnati Children's Hospital's Attention Deficit Hyperactivity Disorder (ADHD) Treatment for School Age Children Decision Aid were used in this study. The 6 pre-visit cards provide an overview of ADHD treatment options, the respective benefits and downsides of each option, and questions to elicit goals/preferences. The four different treatment options presented were: (1) watchful waiting, (2) behavioral treatment, (3) medication treatment, and (4) combined treatment (behavioral and medication together).
Control Arm
Participants in this group will not receive any educational materials.
Overall Study
STARTED
252
260
Overall Study
COMPLETED
242
256
Overall Study
NOT COMPLETED
10
4

Reasons for withdrawal

Reasons for withdrawal
Measure
Decision Aid Arm
Participants in this arm will review educational material from the ADHD Decision Aid developed by the Cincinnati Children's Hospital Medical Center. Attention Deficit Hyperactivity Disorder Treatment Decision Aid: The parent pre-visit cards from the Cincinnati Children's Hospital's Attention Deficit Hyperactivity Disorder (ADHD) Treatment for School Age Children Decision Aid were used in this study. The 6 pre-visit cards provide an overview of ADHD treatment options, the respective benefits and downsides of each option, and questions to elicit goals/preferences. The four different treatment options presented were: (1) watchful waiting, (2) behavioral treatment, (3) medication treatment, and (4) combined treatment (behavioral and medication together).
Control Arm
Participants in this group will not receive any educational materials.
Overall Study
inconsistent answers for main decision for adhd treatment
9
0
Overall Study
did not have sufficient information to calculate the SDM Process score (primary outcome)
1
4

Baseline Characteristics

Refining the Shared Decision Making Process Survey in ADHD Medication Decisions

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Decision Aid Arm
n=242 Participants
Participants in this arm will review educational material from the ADHD Decision Aid developed by the Cincinnati Children's Hospital Medical Center. Attention Deficit Hyperactivity Disorder Treatment Decision Aid: The parent pre-visit cards from the Cincinnati Children's Hospital's Attention Deficit Hyperactivity Disorder (ADHD) Treatment for School Age Children Decision Aid were used in this study. The 6 pre-visit cards provide an overview of ADHD treatment options, the respective benefits and downsides of each option, and questions to elicit goals/preferences. The four different treatment options presented were: (1) watchful waiting, (2) behavioral treatment, (3) medication treatment, and (4) combined treatment (behavioral and medication together).
Control Arm
n=256 Participants
Participants in this group will not receive any educational materials.
Total
n=498 Participants
Total of all reporting groups
Age, Continuous
37.7 years
STANDARD_DEVIATION 5.2 • n=5 Participants
37.5 years
STANDARD_DEVIATION 5.8 • n=7 Participants
37.6 years
STANDARD_DEVIATION 5.5 • n=5 Participants
Sex/Gender, Customized
Female
166 Participants
n=5 Participants
172 Participants
n=7 Participants
338 Participants
n=5 Participants
Sex/Gender, Customized
Male
75 Participants
n=5 Participants
84 Participants
n=7 Participants
159 Participants
n=5 Participants
Sex/Gender, Customized
Unknown
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Race/Ethnicity, Customized
Hispanic Only
20 Participants
n=5 Participants
19 Participants
n=7 Participants
39 Participants
n=5 Participants
Race/Ethnicity, Customized
White, non Hispanic
168 Participants
n=5 Participants
169 Participants
n=7 Participants
337 Participants
n=5 Participants
Race/Ethnicity, Customized
Black
30 Participants
n=5 Participants
34 Participants
n=7 Participants
64 Participants
n=5 Participants
Race/Ethnicity, Customized
Asian
7 Participants
n=5 Participants
13 Participants
n=7 Participants
20 Participants
n=5 Participants
Race/Ethnicity, Customized
Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race/Ethnicity, Customized
American Indian
2 Participants
n=5 Participants
2 Participants
n=7 Participants
4 Participants
n=5 Participants
Race/Ethnicity, Customized
Other
3 Participants
n=5 Participants
6 Participants
n=7 Participants
9 Participants
n=5 Participants
Race/Ethnicity, Customized
Multiple Races
10 Participants
n=5 Participants
8 Participants
n=7 Participants
18 Participants
n=5 Participants
Race/Ethnicity, Customized
Unknown
2 Participants
n=5 Participants
5 Participants
n=7 Participants
7 Participants
n=5 Participants
Region of Enrollment
United States
242 participants
n=5 Participants
256 participants
n=7 Participants
498 participants
n=5 Participants

PRIMARY outcome

Timeframe: baseline survey (reflecting on the last 24 months)

Population: participants who provided enough information to calculate a shared decision making process score (primary outcome of interest). 498/498 patients provided an answer to this question.

The Shared Decision Making Process scale is a short patient-reported survey that measures the amount of shared decision making that occurs in an interaction. Scores range from 0-4 where higher values indicate a better shared decision making process occurred.

Outcome measures

Outcome measures
Measure
Decision Aid Arm
n=242 Participants
Participants in this arm will review educational material from the ADHD Decision Aid developed by the Cincinnati Children's Hospital Medical Center. Attention Deficit Hyperactivity Disorder Treatment Decision Aid: The parent pre-visit cards from the Cincinnati Children's Hospital's Attention Deficit Hyperactivity Disorder (ADHD) Treatment for School Age Children Decision Aid were used in this study. The 6 pre-visit cards provide an overview of ADHD treatment options, the respective benefits and downsides of each option, and questions to elicit goals/preferences. The four different treatment options presented were: (1) watchful waiting, (2) behavioral treatment, (3) medication treatment, and (4) combined treatment (behavioral and medication together).
Control Arm
n=256 Participants
Participants in this group will not receive any educational materials.
Shared Decision Making Process Score
2.83 units on a scale
Standard Deviation 1.06
2.77 units on a scale
Standard Deviation 1.04

SECONDARY outcome

Timeframe: baseline survey

Population: participants who completed at least 60% of the knowledge questions. Only 478/498 participants provided sufficient information to calculate a knowledge score.

Multiple choice knowledge items are scored correct/incorrect and a total knowledge score (0-100%) is calculated with higher scores indicating higher knowledge.

Outcome measures

Outcome measures
Measure
Decision Aid Arm
n=239 Participants
Participants in this arm will review educational material from the ADHD Decision Aid developed by the Cincinnati Children's Hospital Medical Center. Attention Deficit Hyperactivity Disorder Treatment Decision Aid: The parent pre-visit cards from the Cincinnati Children's Hospital's Attention Deficit Hyperactivity Disorder (ADHD) Treatment for School Age Children Decision Aid were used in this study. The 6 pre-visit cards provide an overview of ADHD treatment options, the respective benefits and downsides of each option, and questions to elicit goals/preferences. The four different treatment options presented were: (1) watchful waiting, (2) behavioral treatment, (3) medication treatment, and (4) combined treatment (behavioral and medication together).
Control Arm
n=239 Participants
Participants in this group will not receive any educational materials.
ADHD Knowledge
68.37 percentage of correct answers
Standard Deviation 22.85
59.9 percentage of correct answers
Standard Deviation 18.99

SECONDARY outcome

Timeframe: baseline survey

Population: participants who answered all 4 items of the decisional conflict scale. Only 485/498 provided sufficient information to calculate a SURE score.

Measures decisional conflict, consists of 4 yes/no items. Scores range 0-4 where 0 indicates extremely high decisional conflict, 4 indicates no decisional conflict. The number who get score of 4 is reported indicating no decisional conflict. This reports number of participants were reported no decision conflict.

Outcome measures

Outcome measures
Measure
Decision Aid Arm
n=235 Participants
Participants in this arm will review educational material from the ADHD Decision Aid developed by the Cincinnati Children's Hospital Medical Center. Attention Deficit Hyperactivity Disorder Treatment Decision Aid: The parent pre-visit cards from the Cincinnati Children's Hospital's Attention Deficit Hyperactivity Disorder (ADHD) Treatment for School Age Children Decision Aid were used in this study. The 6 pre-visit cards provide an overview of ADHD treatment options, the respective benefits and downsides of each option, and questions to elicit goals/preferences. The four different treatment options presented were: (1) watchful waiting, (2) behavioral treatment, (3) medication treatment, and (4) combined treatment (behavioral and medication together).
Control Arm
n=250 Participants
Participants in this group will not receive any educational materials.
Decisional Conflict Tool (SURE)
164 Participants
184 Participants

SECONDARY outcome

Timeframe: baseline survey

Population: Participants who answered the single-item regret question. Only 497/498 participants provided sufficient information to calculate regret.

Single item asking "If you knew then what you know now, do you think you would make the same decision. Response options are: Definitely yes, Probably yes, Probably no, Definitely no.

Outcome measures

Outcome measures
Measure
Decision Aid Arm
n=242 Participants
Participants in this arm will review educational material from the ADHD Decision Aid developed by the Cincinnati Children's Hospital Medical Center. Attention Deficit Hyperactivity Disorder Treatment Decision Aid: The parent pre-visit cards from the Cincinnati Children's Hospital's Attention Deficit Hyperactivity Disorder (ADHD) Treatment for School Age Children Decision Aid were used in this study. The 6 pre-visit cards provide an overview of ADHD treatment options, the respective benefits and downsides of each option, and questions to elicit goals/preferences. The four different treatment options presented were: (1) watchful waiting, (2) behavioral treatment, (3) medication treatment, and (4) combined treatment (behavioral and medication together).
Control Arm
n=255 Participants
Participants in this group will not receive any educational materials.
Single-item Measure of Decision Regret
Definitely Yes
100 Participants
102 Participants
Single-item Measure of Decision Regret
Probably Yes
116 Participants
123 Participants
Single-item Measure of Decision Regret
Probably No
18 Participants
25 Participants
Single-item Measure of Decision Regret
Definitely No
8 Participants
5 Participants

SECONDARY outcome

Timeframe: baseline survey

Population: Participants who answered the question. All 498 participants provided sufficient information for treatment choice.

1 item that asked parents if their child is currently taking medication to treat their ADHD.

Outcome measures

Outcome measures
Measure
Decision Aid Arm
n=242 Participants
Participants in this arm will review educational material from the ADHD Decision Aid developed by the Cincinnati Children's Hospital Medical Center. Attention Deficit Hyperactivity Disorder Treatment Decision Aid: The parent pre-visit cards from the Cincinnati Children's Hospital's Attention Deficit Hyperactivity Disorder (ADHD) Treatment for School Age Children Decision Aid were used in this study. The 6 pre-visit cards provide an overview of ADHD treatment options, the respective benefits and downsides of each option, and questions to elicit goals/preferences. The four different treatment options presented were: (1) watchful waiting, (2) behavioral treatment, (3) medication treatment, and (4) combined treatment (behavioral and medication together).
Control Arm
n=256 Participants
Participants in this group will not receive any educational materials.
Treatment Choice
taking medication
151 Participants
146 Participants
Treatment Choice
not taking medication
91 Participants
110 Participants

SECONDARY outcome

Timeframe: baseline survey

Population: Participants provided sufficient information to calculate a total score. Only 483/498 participants provided sufficient information

8 items that ask parents to rate their child's performance in school overall, in individual subjects such as reading, relationships with others such as parents and peers, and their participation in organized activities. There were 5 response options: Excellent, above average, average, somewhat of a problem, and problematic. Total scores range from 8 to 40 with higher scores indicating more problematic behavior

Outcome measures

Outcome measures
Measure
Decision Aid Arm
n=235 Participants
Participants in this arm will review educational material from the ADHD Decision Aid developed by the Cincinnati Children's Hospital Medical Center. Attention Deficit Hyperactivity Disorder Treatment Decision Aid: The parent pre-visit cards from the Cincinnati Children's Hospital's Attention Deficit Hyperactivity Disorder (ADHD) Treatment for School Age Children Decision Aid were used in this study. The 6 pre-visit cards provide an overview of ADHD treatment options, the respective benefits and downsides of each option, and questions to elicit goals/preferences. The four different treatment options presented were: (1) watchful waiting, (2) behavioral treatment, (3) medication treatment, and (4) combined treatment (behavioral and medication together).
Control Arm
n=248 Participants
Participants in this group will not receive any educational materials.
National Initiative for Children's Healthcare Quality (NICHQ) Vanderbilt Assessment Performance Sub-scale
22.46 score on a scale
Standard Deviation 6.38
21.07 score on a scale
Standard Deviation 6.26

SECONDARY outcome

Timeframe: baseline survey

Population: Participants who answered the single-item question. Only 497/498 participants provided sufficient information.

Single item asking the parent who made the ultimate decision. The categorical response options are 1) the parent made the decision, 2)the child's provider made the decision, 3) both parent and provider made the decision together, or 4) the decision as made by someone else

Outcome measures

Outcome measures
Measure
Decision Aid Arm
n=241 Participants
Participants in this arm will review educational material from the ADHD Decision Aid developed by the Cincinnati Children's Hospital Medical Center. Attention Deficit Hyperactivity Disorder Treatment Decision Aid: The parent pre-visit cards from the Cincinnati Children's Hospital's Attention Deficit Hyperactivity Disorder (ADHD) Treatment for School Age Children Decision Aid were used in this study. The 6 pre-visit cards provide an overview of ADHD treatment options, the respective benefits and downsides of each option, and questions to elicit goals/preferences. The four different treatment options presented were: (1) watchful waiting, (2) behavioral treatment, (3) medication treatment, and (4) combined treatment (behavioral and medication together).
Control Arm
n=256 Participants
Participants in this group will not receive any educational materials.
Adapted Controlled Preference Scale
Mainly you
109 Participants
119 Participants
Adapted Controlled Preference Scale
Mainly your child's healthcare provider
22 Participants
27 Participants
Adapted Controlled Preference Scale
You and the provider made the decision together
108 Participants
110 Participants
Adapted Controlled Preference Scale
Mainly someone else
2 Participants
0 Participants

SECONDARY outcome

Timeframe: 2 weeks after completing the baseline survey

Population: A subset of participants who completed the baseline survey were re-contacted approximately 2 weeks post baseline survey for a retest. Participants who completed the retest survey and provided enough information to calculate the shared decision making process score were part of this analysis. 208/215 provided both consistent and sufficient information.

The Shared Decision Making Process is a short patient-reported survey that measures the amount of shared decision making that occurs in an interaction. Scores range from 0-4 where higher values indicate a better shared decision making process occurred.

Outcome measures

Outcome measures
Measure
Decision Aid Arm
n=98 Participants
Participants in this arm will review educational material from the ADHD Decision Aid developed by the Cincinnati Children's Hospital Medical Center. Attention Deficit Hyperactivity Disorder Treatment Decision Aid: The parent pre-visit cards from the Cincinnati Children's Hospital's Attention Deficit Hyperactivity Disorder (ADHD) Treatment for School Age Children Decision Aid were used in this study. The 6 pre-visit cards provide an overview of ADHD treatment options, the respective benefits and downsides of each option, and questions to elicit goals/preferences. The four different treatment options presented were: (1) watchful waiting, (2) behavioral treatment, (3) medication treatment, and (4) combined treatment (behavioral and medication together).
Control Arm
n=110 Participants
Participants in this group will not receive any educational materials.
Shared Decision Making Process Measure Retest
2.84 score on a scale
Standard Deviation 1.01
2.60 score on a scale
Standard Deviation 1.02

OTHER_PRE_SPECIFIED outcome

Timeframe: baseline survey

Population: only parents who stated their child was currently taking medicine was included in this analysis. 297 parents said their child was taking medicine, and 290/297 provided information on adherence

1 item measure of adherence to medication for sample of participants who indicated their child was taking medicine. The question asked "in the last 30 days, how often did your child take their ADHD medicine in the way they were supposed to?"

Outcome measures

Outcome measures
Measure
Decision Aid Arm
n=149 Participants
Participants in this arm will review educational material from the ADHD Decision Aid developed by the Cincinnati Children's Hospital Medical Center. Attention Deficit Hyperactivity Disorder Treatment Decision Aid: The parent pre-visit cards from the Cincinnati Children's Hospital's Attention Deficit Hyperactivity Disorder (ADHD) Treatment for School Age Children Decision Aid were used in this study. The 6 pre-visit cards provide an overview of ADHD treatment options, the respective benefits and downsides of each option, and questions to elicit goals/preferences. The four different treatment options presented were: (1) watchful waiting, (2) behavioral treatment, (3) medication treatment, and (4) combined treatment (behavioral and medication together).
Control Arm
n=141 Participants
Participants in this group will not receive any educational materials.
Adherence
Never
5 Participants
5 Participants
Adherence
Almost Always
30 Participants
34 Participants
Adherence
Rarely
8 Participants
8 Participants
Adherence
Sometimes
21 Participants
17 Participants
Adherence
Usually
16 Participants
16 Participants
Adherence
Always
69 Participants
61 Participants

Adverse Events

Decision Aid Arm

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Control Arm

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Karen R. Sepucha

Massachusetts General Hospital

Phone: 617-724-3350

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place