Mississippi Pharmacists' Perceptions and Knowledge of ADHD in Children By Anna Crider A thesis ...

57 Pages·2017·0.74 MB·English

Mississippi Pharmacists' Perceptions and Knowledge of ADHD in Children

By

Anna Crider

A thesis submitted to the faculty of The University of Mississippi in partial fulfillment of
the requirements of the Sally McDonnell Barksdale Honors College

Oxford

March 2017

Approved by

__________________________________
Advisor: Professor Erin Holmes

__________________________________
Reader: Professor John Young

__________________________________
Reader: Professor David Gregory
© 2017
Anna Crider
ALL RIGHTS RESERVED

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ACKNOWLEDGEMENTS
I would first like to thank the University of Mississippi School of Pharmacy and
the Sally McDonnell Barksdale Honors College. Without their provision of resources and
opportunities, this project would have never been possible. Additionally the work, help,
and guidance of my advisor, Dr. Erin Holmes, have been immeasurable, and I am grateful
for her expertise and knowledge on how to conduct a survey-based research project. I
would also like to thank my parents, whose support and love over my life have helped
foster my academic curiosity that drove me to conduct this study.

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ABSTRACT

Mississippi Pharmacists’ Perceptions and Knowledge of ADHD in Children

Attention-deficit/hyperactivity disorder (ADHD) is a condition that has garnered
more attention in the profession of pharmacy in recent years as a result of being more
commonly diagnosed in both adult and pediatric populations. With new medications
available, pharmacists need to be knowledgeable about how these products may affect
patients, especially children. It is crucial to understand pharmacists’ perceptions and
knowledge of ADHD and its treatments to optimize their provision of treatment for these
patients. Due to the lack of literature dedicated to pharmacists’ knowledge, familiarity,
confidence, and perceptions as it relates the condition of ADHD and its treatments, the
objectives of this study are to measure community pharmacists’ knowledge of, familiarity
with, confidence in counseling for, and perceptions of, ADHD and associated treatments
for children. The study objectives were met by employing a descriptive, cross-sectional
design. Responses were generated using a self-administered survey that was distributed
electronically to Mississippi pharmacists using Qualtrics Survey Software. The results of
this study demonstrate that Mississippi pharmacists are generally knowledgeable and
comfortable in their role as dispensers of ADHD medications for children and also in
counseling patients and families about those medications. However, there still appears to
be some need for supplemental education in the form of continuing education or
enhanced pharmacy school education to reinforce pharmacists’ knowledge about
pharmacological treatments. Pharmacists were less knowledgeable and familiar with
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diagnosis of ADHD and non-pharmacological treatments, which is expected given their
practice area. The question to be asked is whether education for pharmacists in these
latter areas is necessary, especially if they are not specialists in ADHD. It can be argued
that pharmacists would benefit from training in ADHD outside of pharmacological
treatments. As the most accessible healthcare professional, pharmacists are likely to be
called on by families of patients with ADHD for guidance. Additionally, a collaborative
healthcare team approach should be taken between doctor, pharmacist, and therapist to
ensure the patient’s ADHD is not only being handled through medication therapy, but
through a holistic approach.

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TABLE OF CONTENTS
LIST OF TABLES……………………………………………………...........................VII
LIST OF FIGURES……………………………………………………………………VIII
LIST OF SYMBOLS AND ABBREVIATIONS………………......................................IX
BACKGROUND……………………………………...………………….…….…………1
METHODS……………………………………………..……………….……………….18
RESULTS………………………………………………..………………………….…...22
DISCUSSION……………………………………….…….………………………….….33
REFERENCES………………………………………………………………….……….40
APPENDICES……………………………………………..……….……………………42

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List of Tables
Table 1: Inattention Symptoms of ADHD……………………………………………..4
Table 2: Hyperactivity and Impulsivity………………………………………………..4
Table 3: Demographic Characteristics………………………………………………...23
Table 4: Pharmacists’ Familiarity with ADHD……………………………………….24
Table 5: Pharmacists’ Knowledge of ADHD…………………………………………26
Table 6: Pharmacists’ Confidence with ADHD………………………………………30
Table 7: Pharmacists’ Perceptions of ADHD…………………………………………31

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List of Figures
Figure 1: Knowledge Item 1…………………………………………………………… 27
Figure 2: Knowledge Item 4 Responses between BS and PharmD Respondents………28
Figure 3: Knowledge Item 2 Responses between BS and PharmD Respondents………28
Figure 4: Knowledge Item 6 Responses between Independent and Retail Chain
Pharmacists………………………………………………………………………….......29
Figure 5: Perception Item 2 Responses between BS and PharmD Respondents……......32

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List of Symbols and Abbreviations
ADD: Attention Deficit Disorder
ADHD: Attention-deficit/hyperactivity disorder
BRIEF: Behavior Rating Inventory of Executive Function
BS: Bachelor’s Degree in Pharmacy
CBT: Cognitive Behavioral Therapy
CDC: Centers for Disease Control
CE: Continuing Education
CPTs: Continuous Performance Tests
CPT-II: Conners’ Continuous Performance Test-II
C-2 or C-II: Schedule 2 Controlled Substance
DSM: Diagnostic Statistical Manual
IRB: Institutional Review Board
MS: Master’s Degree in Pharmacy
MTA: Multimodal Treatment Study of Children with Attention Deficit Hyperactivity
Disorder
PADDS: Pediatric Attention Disorders Diagnostic Screener
PharmD: Doctor of Pharmacy Degree
PhD: Doctor of Philosophy in Pharmacy
TOVA: Test of Variables of Attention
TTEFs: Target Tests of Executive Functioning
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BACKGROUND
Description of the Problem
5.4 million children between the ages of 4 and 17 have been diagnosed with it as
of 2007, and 2.7 million are receiving medical therapy due to it. Boys are almost three
times more likely to have it than girls, but only 3-7% of school aged children have it
(ADHD Data and Statistics in the USA). Attention Deficit Hyperactivity Disorder
(ADHD) is an ever-present diagnosis on the rise in the minds of Americans. Over the last
two decades, this disorder has grown from unknown to colloquial language throughout
various communities, especially academic. In the United States, the western states have
almost a ten-fold decrease in ADHD rates compared to the midwestern states; which
include some of the highest with Kentucky at a 14.8% ADHD rate (ADHD by the
Numbers: Facts, Statistics, and You).
Across all disciplines, the Centers for Disease Control (CDC) reports that 11% of
American children have ADHD, a 42% increase in just a short eight years from 2003-
2011 (ADHD by the Numbers: Facts, Statistics, and You). According to post-doctoral
fellow Meg Reuland who works at the Judge Baker Children’s Center in Boston,
Massachusetts, young women are less represented in the diagnosis of ADHD due to the
premise that young girls tend to show the inattentive symptoms of ADHD, as opposed to
the obvious hyperactive symptoms more typically displayed in boys with ADHD. The
inattentive symptoms go unnoticed because it appears that the girl is disinterested and
spacey and not symptomatic of ADHD (Interview with Meg Reuland). The disorder is
diagnosed far and wide not only across the United States, but also in European countries
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