Analysis of Patients' Preferences: Direct Assessment and Discrete-Choice Experiment in Therapy of Adults with Attention-Deficit Hyperactivity Disorder

Background: Attention-deficit hyperactivity disorder (ADHD) is a complex neuropsychiatric disorder that affects children and young people, as well as adults. Since ADHD does not produce specific organic characteristics, behavior and preferences are crucial to diagnosis and treatment. Comprehensive therapy concepts should take full account of the needs of the patients. Objective: To document therapy attributes that are important from the adults' perspective and to analyze findings from two different valuation approaches used in the same survey. Methods: A self-administered survey measuring attitudes and preferences was conducted in Germany in 2009 (n - 329). Adult patients (aged ≥18 years) were recruited from all over Germany, with the help of patient advocacy organizations. Attitudes were measured and analyzed using a classic rating scale in 5-point Likert format. Discrete-choice experiment (DCE) scenarios were developed using a fractional factorial design and results were analyzed using random effects logit models. Results: The aspect of highest importance for the respondents was that social function (job, studies, friendships) was not impaired (coefficient 2.115; standard error 0.111). The next most important in the view of the respondents was achievement of behavioral changes through treatment (coefficient 1.755; standard error 0.110). The 'drug intake' aspect was not important in the attitude component rating and not significant in the DCE. Conclusions: The primary goal of ADHD treatment is by no means the alleviation of core symptoms. Instead, therapy should help enable patients to set and achieve their own objectives. Treatment should enable patients to organize their social participation in everyday life.