Importance of Adherence to Medication in ADHD: A Qualitative Research

This paper discusses the importance of adherence to medication in ADHD through a qualitative research study. It explores the experiences of individuals with ADHD and their medication management. The findings highlight the need for proper education and support for patients and their families. The research articles used in the discussion provide valuable insights into the challenges and strategies for improving medication adherence in ADHD.

Running head: HEALTHCARE ASSIGNMENT
QUALITATIVE RESEARCH ASSIGNMENT
Name of the student
Name of the university
Author note

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Introduction
Attention Deficit Hyperactivity Disorder (ADHD) is the disorder is a major health
concern for children around the world due to which, more than 11% of the children and 4.4% of
the adult population of the United States of America is affected (Gray et al., 2018). As per the
research of Schaefer et al. (2019), men and boys are more likely to acquire this disorder than
women and girls however, no such data regarding the reason of this has been found. Further, it
was also seen that populations with low socio- economic status and more disadvantaged
situations are likely to develop this syndrome, as well as the family history and parental effects
also causes disparity in the population (Martel, 2018). Several symptoms associated with
disorder are low frustration tolerance, enhanced impulsiveness, restlessness, poor time
management and planning abilities and disorganized behavior (Noble & Smith, 2015). Therefore,
there are several medications available, adherence to which,could improve the patient condition
and symptoms associated to ADHD. However as per Ahmed, McCaffery and Aslani (2016)
majority of the patients do not continue their medications after their first line treatment due to
which, the relapse of this disease is observed in their adulthood.
Therefore, the primary aim of this paper to identify the goal of this paper is to conduct
qualitative research so that the importance of adherence to medication could be assessed
(Fridman et al., 2017). Further, in this process, to primary literatures would be selected from
databases such as google scholar and Pub Med and critical appraisal of those articles using
Joanna Briggs critical appraisal tool would be conducted so that importance of their interventions
and application of them in the process for the increased adherence of medication in ADHD could
be assessed. Therefore, the thesis statement that would be achieved after completion of this

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paper would be: adherence to medications could eliminate the risk of ADHD in children as
well as prevents relapse in adulthood.
Qualitative study
Qualitative research process is the in-depth understanding which is done based on the
naturalistic inquiry and role of social phenomenon in causing the process (Abdulghani et al.,
2014). It was seen that besides logical and statistical phenomenon this research process helps to
conduct historical analysis, ethnography, different theory and biographies so that holistic
understanding the process could be achieved (Donnellan, Bennett & Soulsby, 2015). Therefore,
through this research process, researchers are able to conduct the enquiry and through their
opinions, reasoning skills and the motivations, it helps to provide a detailed insight about the
patient and their associated problem in research process (Abdulghani et al., 2014). Further, the
aspects of research that are not mentioned in the quantitate research such as beliefs, values,
motivations and behavior of the people involved in the research, are included in the qualitative
study (Donnellan, Bennett & Soulsby, 2015).
Hence, while applying the qualitative research method in the APN practice, the,
nursing professionals would require proper research and evidences conducted in the past so that
through these, they could understand the processes they could apply within their own
organization to research about their point of interest. Hutchinson et al. (2014) mentions that
evidence based nursing practice is the best method to understand the ways which the nursing
professionals could use for conduction of research about their subject and in the process they
could seek assistance from their supervisors of senior nursing and healthcare professionals so
that they methods, belief, methodologies, motivations and opinion could be used to determine the
effectiveness of the research (Donnellan, Bennett & Soulsby, 2015).

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Data collection
Data collection is the crucial process of qualitative study and in the process, it is
important to assess all the responses achieved after the qualitative research (Alshenqeeti, 2014).
The primary process, which is used for the data collection in qualitative study are group
discussions interviews, observational study, group discussion and so on in which participants are
directly asked about their experiences and the interventions they should think would be helpful in
overcoming the concern in the question (Cleary, Horsfall & Hayter, 2014). In this process, to
understand the effectiveness of medication adherence to improve patient with ADHD condition,
interviews with all the affected individuals would be conducted so that their cognitive abilities,
their narration of recovery could be understood (Alshenqeeti, 2014). Further, observation of their
recovery would be achieved so that the presence of medication and health improvement could be
properly assessed (Cleary, Horsfall & Hayter, 2014).
Article Discussion
To understand the type of qualitative studies that have been conducted so that the
compliance of medication prevalence for ADHD affected people could be addressed. In this
discussion the purpose and overview of the study, the study design and methodology would be
provided and the while completion of the process, different concepts such as dependability,
transferability, conformability would be applied.
The first article which would be discussed in this aspect is conducted by Schaefer et al.
(2017), in which the primary purpose of the researchers was to understand the medication and
self management experiences of adolescent population, who recently shifted from young
adulthood to college and are suffering from ADHD. The findings of this research determined the
fact that majority of the participants of the research process, do not took care of their ADHD

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medications, and hence, their academic performance affected (Schaefer et al., 2017). Further the
finding also indicated to the fact that social isolation and discrimination was also a limiting
factor for the medication and self- management of the ADHD condition. However, the factor
which should be noted in this condition is that as per the participants, they needed the
intervention primarily while their transition to independent as it was an important factor for
success of the patients in college scenario (Schaefer et al., 2017).
The design and methodology of the study was phenomenological approach depending
on which 10 college freshmen from southeastern university and while finalizing the participants,
individuals, living alone, in second semester of their study, more than 21 year of age and under
the medication of the ADHD were selected for the participation. Besides this in the methodology
section, Health Belief Model (HBM) was used for the interview process (Schaefer et al., 2017).
The method of interview included a pen-paper questionnaire and then conducted a 2 hour long
interventions so that their self-management and medication assessment could be identified.
Besides these, there are several concepts of qualitative research which is identified in the study
(Schaefer et al., 2017). These concepts were of transferability, dependability, and credibility
and these concepts could be easily identified in the study (Leung, 2015). As the research in topic
assessed the ability of the adolescent individuals about their medication and self-management of
ADHD, results of these could be easily applied to the other settings and contexts and hence,
acceptability and transferability of the research increased. Further, due to the qualitative study,
the study eliminated the chances of obtaining same results repeatedly that increased the
reliability of the study and decreased the dependency of the research on the provided situation.
Finally, the concept of credibility of the research was effective as the participants had complete

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trust on the research process and as per Noble and Smith (2015), participants could judge the
process of the research.
On the other hand, the second article Ahmed et al. (2014) had the purpose of
understanding the knowledge of parents regarding the ADHD condition of their children and
then assesses the educational resources used by the parents for their children’s ADHD condition.
Further, the decision of parents regarding the strategies to address the need of the patients could
be assessed (Ahmed et al., 2014). The findings of the research paper mentioned that parents had
very limited knowledge of their children’s ADHD condition and due to their limited knowledge
prior to the detection of their child’s ADHD condition, perceived the mediation for this health
condition as negative impact for their children. Further, the parents mentioned that they were not
provided with complete education and the complete education was based on verbal education
and as the parents, they should be provided with detailed and tailored information regarding
ADHD and hence, this would be important for providing the patients with detailed medication
and assistance (Ahmed et al., 2014). The design and methodology of the research included three
focused groups in which 16 parents were included and with them interview for 1 to 1.5 hour
conducted. Further the transcript of the process would be used to determine the method and
theme of the research. Finally, while determining the research analysis, three concepts of
credibility, transferability and confirm ability was identified in the research (Ahmed et al., 2014).
As the research identified aspects which could be applied to any disease and context, the
application of the research findings could be used to provide education of patients and their
families (Noble & Smith, 2015). Hence, it increased the credibility and transformability of the
process. Further, it was seen that applied strategies for parent’s education about ADHD, could

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also advocate for the patient and family education for the effective care of ADHD. Hence,
confirmed effectiveness of the process was witnessed (Leung, 2015).
Application of the articles
Application of the research articles on the point of interest of this paper is an important
process which depends on the level of evidence and grade of recommendation of the chosen
articles (Schaefer et al., 2017). This is an important aspect for alignment as complying with it
could enhance the effectiveness of the research and the findings could be applied to majority of
the research process (Ahmed et al., 2014). The articles selected for the discussion in this paper
belonged to the Level III evidence in the John Hopkins nursing evidence based practice, as they
were qualitative study in which interviews and questionnaire were used for the research process
(Murphy et al., 2017). Further, the recommendation grade selected for this article was both of
good quality for recommending in future research articles (Schaefer et al., 2017). This is
because, through this, they were provided with sufficient sample size, proper study design,
consisted results definitive conclusion and were also provided with recommendations as they
were included with proper literature review so that the scientific evidences could be included in
the study (Ahmed et al., 2014).
Conclusion
ADHD is a critical health condition in which not only the patients, but the families
included in the study should also be provided with proper education and information about
medication, healthcare needs complications so that while completion of the interventions,
complete support could be obtained. This paper discussed about the ADHD disorder and also
mentioned the importance of adherence to medication through the discussion of two research
articles so that complete analysis of the important factors to adhere to the medication could be

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obtained. Further, in the appendix section, evidence based tool and review matrix of the two
selected articles and Joanna- Briggs critical appraisal tool has been mentioned, to complete the
analysis of the research.

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References
Abdulghani, H. M., Al-Drees, A. A., Khalil, M. S., Ahmad, F., Ponnamperuma, G. G., & Amin,
Z. (2014). What factors determine academic achievement in high achieving
undergraduate medical students? A qualitative study. Medical teacher, 36(sup1), S43-
S48. DOI: https://doi.org/10.3109/0142159X.2014.886011
Ahmed, R., Borst, J. M., Yong, C. W., & Aslani, P. (2014). Do parents of children with
attention-deficit/hyperactivity disorder (ADHD) receive adequate information about the
disorder and its treatments? A qualitative investigation. Patient preference and
adherence, 8, 661. DOI: 10.2147/PPA.S60164.
Ahmed, R., McCaffery, K. J., & Aslani, P. (2016). Development and validation of a question
prompt list for parents of children with attention‐deficit/hyperactivity disorder: a Delphi
study. Health Expectations, 19(2), 234-252. DOI: https://doi.org/10.1111/hex.12341
Alshenqeeti, H. (2014). Interviewing as a data collection method: A critical review. English
Linguistics Research, 3(1), 39-45. DOOI: 10.5430/elr.v3n1p39
Cleary, M., Horsfall, J., & Hayter, M. (2014). Data collection and sampling in qualitative
research: does size matter?. Journal of advanced nursing, 70(3), 473-475. DOI:
https://doi.org/10.1111/jan.12163
Donnellan, W. J., Bennett, K. M., & Soulsby, L. K. (2015). What are the factors that facilitate or
hinder resilience in older spousal dementia carers? A qualitative study. Aging & mental
health, 19(10), 932-939. DOI: https://doi.org/10.1080/13607863.2014.977771

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Fridman, M., Banaschewski, T., Sikirica, V., Quintero, J., & Chen, K. S. (2017). Access to
diagnosis, treatment, and supportive services among pharmacotherapy-treated
children/adolescents with ADHD in Europe: data from the Caregiver Perspective on
Pediatric ADHD survey. Neuropsychiatric disease and treatment, 13, 947. DOI:
https://dx.doi.org/10.2147%2FNDT.S128752
Gray, W. N., Kavookjian, J., Shapiro, S. K., Wagoner, S. T., Schaefer, M. R., Rawlinson, A. R.,
& Hinnant, J. B. (2018). Transition to college and adherence to prescribed attention
deficit hyperactivity disorder medication. Journal of Developmental & Behavioral
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4863.161306
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to College with a Mental Health Condition. In Promoting Safe and Effective Transitions
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https://doi.org/10.1007/978-3-319-68894-7_1
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for maximising the inclusion of people with dementia in qualitative research

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studies. Dementia, 14(6), 800-824. Retrieved from:
https://journals.sagepub.com/doi/abs/10.1177/1471301213512489

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Noble, H., & Smith, J. (2015). Issues of validity and reliability in qualitative research. Evidence-
based nursing, 18(2), 34-35. DOI: http://dx.doi.org/10.1136/eb-2015-102054
Schaefer, M. R., Rawlinson, A. R., Wagoner, S. T., Shapiro, S. K., Kavookjian, J., & Gray, W.
N. (2017). Adherence to attention-deficit/hyperactivity disorder medication during the
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https://doi.org/10.1016/j.jadohealth.2016.12.011
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10.1097/DBP.0000000000000602

Running head: HEALTHCARE ASSIGNMENT
Appendix
Author(s), Title,
Year
Question Design
(Quantitative/Qualitative)
RCT, SR, MA, Cohort,
etc.
Sample and
description
Data Collection
Methods
Findings&
Limitations to
study
Level of
Evidence/tool
used
Authors:
Schaefer
MR, Rawlinson
AR, Wagoner ST,
Shapiro
SK, Kavookjian
J, Gray WN
Name:
Adherence to
Attention-
Deficit/Hyperacti
The purpose of
the study was
to express the
self medication
and medication
experiences of
the participants
included in the
study and
undergoing
transition from
Descriptive and qualitative
with interview and survey
10 freshmen of
college with 21
years age, in their
second semester
and living away
from their home
were selected.
Interview was
conducted and
replies were
arranged in five
themes such as
transition to
independent, peer
pressure, reason
for non-adherence
to medication,
lack of self
It was found
that patients
were not
aware of the
adherence to
the
medication
and hence
their
educational
Level III John
Hopkins and
Grade B of
recommendatio
ns

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vity Disorder
Medication
During the
Transition to
College
2017
high school to
college with
their ADHD
management and
role of social
support.
performance
also lacked.
Limitation
associated to
long term
follow up
was present
in the
process.
Author: rana
Ahme, Jacqueline
M Borst, cheng
Wei Yong, Parisa
Aslani
Name: Do
parents and
their
knowledge of
ADHD pre and
post level, the
information
Qualitative
investigation study were
conducted
16 parents in
three focus
groups were
included in the
study with whom
1.5 hour
Interview and
investigation
was conducted
so that all the
aim of the
Parents
complained of
not getting
proper
education of
ADHD and
Level III John
Hopkins level
of evidence and
good grade of
recommendatio

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parents of
children with
attention-deficit/
hyperactivity
disorder (ADhD)
receive adequate
information about
the disorder and
its treatments? A
qualitative
investigation
year: 2014
sources they
use for
information of
ADHD,
parents view
about
interventions
and strategies.
discussion and
interview were
conducted and
that script if
interview were
used in the
assessment of the
research.
research could
be obtained
and in the
course the
assessment of
parents and
their
knowledge of
their process
could be
identified.
associated
conditions.
Limitation: no
specific
hypothesis and
investigation
was
formulated.
ns.

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Joanna- Briggs critical appraisal tool
Article name: Adherence to Attention-Deficit/Hyperactivity Disorder Medication During the Transition to College by (Schaefer et
al., 2017)
Questions Yes/no/unclear Remarks
1. Congruence between purpose
and methodology
No As the study mentioned about the
knowledge conducted and collected from
the study, incongruence between the
methodology and purpose of the study
observed.
2. Congruence between
methodology and research
questions
Yes
3. Congruence between collected
data and methodology
Yes
4. Congruence between data
analysis and methodology
Yes

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5. Congruence between results
interpretation and methodology
Yes
6. Does the researchers ethical and
cultural influence is on the
research
No No information regarding the researchers
theoretical an cultural orientation was
provided
7. Does the research was able to
address the influence of both the
researcher and research on each
other?
No No relationship between the researchers
and the participants of the research was
provided in the research which is the
primary factor to determine influence of
both on each-other.
8. Does the participants were
provided with enough freedom to
express themselves?
Yes
9. Ethical consideration of the
research
Yes

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10. Conclusion maintained the flow
of analysis , interpretation
Yes
Article name: Do parents of children with attention-deficit/ hyperactivity disorder (ADhD) receive adequate information about
the disorder and its treatments? A qualitative investigation (Ahmed et al., 2014)
Questions Yes/no/unclear Remarks
1. Congruence between purpose
and methodology
Yes
2. Congruence between
methodology and research
questions
Yes
3. Congruence between collected
data and methodology
Yes
4. Congruence between data
analysis and methodology
Yes
5. Congruence between results Yes

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interpretation and methodology
6. Does the researchers ethical and
cultural influence is on the
research
No This research also lacked the information
about the researchers and their theoretical
an cultural orientation due to which
incongruence were observed
7. Does the research was able to
address the influence of both the
researcher and research on each
other?
No In this research also, no relationship
between the researchers and the
participants included in the research has
been included, which determined the
primary parameter for the determination of
influence on all the participants.
8. Does the participants were
provided with enough freedom to
express themselves?
Yes
9. Ethical consideration of the
research
Yes

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10. Conclusion maintained the flow
of analysis , interpretation
Yes
(As per the requirement, answers with “no” comments has been provided with justification)