สาเหตุของการขาดการติดตามการรักษาอย่างต่อเนื่องในผู้ป่วยโรคสมาธิสั้นวัยเด็กและวัยรุ่น

Abstract

Objective : To examine the reasons of poor treatment adherence in child and adolescents
with attention-deficit/hyperactivity disorder (ADHD) who received psychiatric treatment
at Ramathibodi Hospital.
Method : This was a descriptive cross-sectional study in parents of ADHD patients
under the age of 18 years who received treatment at psychiatric outpatient department,
Ramathibodi Hospital. The data was collected from electronic medical record and
semi-structured telephone interviewing with parents.
Result : There were 35 patients who could be contacted from 62 non-followed-up patients
(77.1% male) with mean age of 10.7 ± 3.4 years. The median of treatment duration
was 6 months. Parents were decision-makers in the case of 74.3% of the subjects and
most subjects who terminated their treatment did not seek other treatments. The main
reasons of poor treatment adherence were poor medication compliance, inconvenience
to attend follow-up appointments, and no symptom. Focusing on the subjects who lost
follow-up in the first 6 months period, the main reasons of poor adherence were side
effects of medications, difficulties in transportation to hospital, poor communication
with psychiatrists and inconvenience to attend follow-up appointments. Regarding
the subjects who lost follow-up after first 6 months period, the main reasons were poor
medication compliance, clinical improvement and inconvenience to attend follow-up
appointments. In general, the level of service satisfaction was good in most aspects.
Conclusion : The reasons of poor treatment adherence when divided by time of treatment
are different. The results of this study help to identify the reasons and to prevent patients
from further follow-up.