ADHD; medication adherence; methylphenidate; parental group intervention; psychoeducation
Objective : To study the effectiveness of parental group intervention for reducing
medication nonadherence in children with ADHD.
Methodology : A quasi-experimental study was conducted at the child and adolescent
outpatient unit, Siriraj Hospital. Subjects were children with newly diagnosed ADHD age
6 to 12 years who were treated with immediate-release methylphenidate. Patients in the
experimental group received medication plus a parental group intervention which
consisted of parental psychoeducation about ADHD and techniques for positive
parenting, whereas patients in the control group received standard medication alone.
Both groups were followed for 6 months. The primary objective was to measure the
percentage of pills taken calculated from pill counts. Secondary objectives included
the change in ADHD symptom severity and functional outcome measured by Thai ADHD
Screening scale (THASS) and Weiss Functional Impairment Rating Scale (WFIRS).
Results : A total of 39 cases completed the study. There was no significant difference
between the experimental and control groups in the percentage of pills taken at 6 months
(81.8% versus 86.5%, respectively; p = 0.545). The experimental group had a significant
reduction in hyperactive/impulsive symptoms compared to controls (percentage of
reduction from baseline 35.4% versus 7.4%, respectively; p = 0.019), but no difference
in reduction in inattentive symptoms nor functional impairment.
Conclusion : The parental group intervention had no significant effect in reducing
medication nonadherence. Further studies are needed to follow up long term outcomes
in larger samples.