William Creed Carleton, PharmD Candidate 

Every October, ADHD Awareness Months brings attention to a common, but still somewhat misunderstood condition that pharmacists encounter on a near daily basis.

 Attention-deficit/hyperactivity disorder (ADHD) is among the most diagnosed neurobehavioral disorders in school-aged children and older, affecting up to 9% of children and 4% of adults.

However, on many occasions, the time leading to this diagnosis can be prolonged due to the perceived stigma that accompanies the diagnosis and the idea that the patient does not have a disorder, but simply does not behave or pay attention. This prolongation can be attributed to several factors, including a lack of information and understanding about what ADHD truly is and what it looks like. Because ADHD is typically a lifelong disorder, information and support are extremely important in the care of patients with ADHD.

Patients have, historically, been very willing to speak with their health care providers about issues that they or their family members are having to get some insight or support in dealing with the issue. The first step in ADHD management is diagnosis. Unfortunately, myths and stigma involving the condition result in many patients remaining undiagnosed.

Although ADHD can require various degrees of diagnostic tests, pharmacists may be among the first health care providers to learn about a patient’s symptoms due in part to the frequency of encounters compared to other clinicians. Whether from a casual conversation or a more formalized consult from a patient or caregiver, pharmacists who detect potential ADHD symptoms can encourage the patient to seek out a provider in the area for a more formal evaluation.

Pharmacists can also reassure patients or caregivers, particularly those who seem hesitant, that they are not the only ones dealing with this. The pharmacist can help identify people, clinicians, and organizations, as well as provide literature that could help the patient and family through the process and provide support.

The pharmacist can be a strong resource for the patient after an ADHD diagnosis is made. For some patients the diagnosis may come as a relief, whereas in other situations, the patient or family may be struggling with a new diagnosis of ADHD due to the stigma associated with a mental disorder or the stigma of taking medication for ADHD.

When presented with such concerns, the pharmacist can help them to better understand the condition, particularly how the management of ADHD works to improve the patient’s overall situation. Misunderstandings about ADHD medications are sadly all too common. Patients may not have a clear understanding of how the medications work, how they differ from illicit substances, or how to maximize medication benefit while minimizing risks and adverse effects.

A young adult or college-aged individual who has been prescribed an ADHD medication may have a sense of embarrassment about taking it because they see it as a crutch, or think that they are too old or should have outgrown the need for it.

Even more so, an adult may see taking an ADHD medication as a weakness and be hesitant to take their medication as they should. The pharmacist should be able to reassure these patients that this is a lifelong condition that does not just affect children and that their medication is beneficial to them.

Pharmacists can also play a role in helping adjust treatment strategies that must evolve over time, as more patients are treated beyond childhood. As people age, their response and tolerance to medications change, therefore the need for a more individualized and adaptive approach to treatment selection is essential.

It is important to recognize that the counseling points may go beyond stimulants and other traditional medication therapies. Newer supplements or non-prescription therapies are becoming available and are frequently marketed directly to the patient using platforms such as social media.

Even after considering the inconsistent efficacy evidence that exists with some of these non-traditional options, the pharmacist should also consider the safety profile and risk, whether it be a direct result of the therapy or is related to a drug or disease interaction. As a chronic condition, the impact of ADHD on social and functional abilities, as well as on other comorbidities, is felt throughout a patient’s life.

Although the pharmacist plays a major role in the medication management of ADHD, they should also remember to integrate non-prescription treatment modalities into their patient counseling. Lifestyle modifications, education accommodations, cognitive behavioral therapies, and other activities all have beneficial roles and are supplemental to the medication management of ADHD.

 Some strategies may be directly related to managing ADHD itself, whereas others may be directed at improving medication adherence, efficacy, and tolerability.

The 2021 theme for ADHD Awareness Month is “Reframing ADHD: discovering new perspectives.”

 It is a good reminder that the pharmacist’s role in ADHD goes much further than just medication dispensing.

Although this is an important aspect of care, the pharmacist is capable of doing much more to benefit the patient and the family. Issues and behaviors associated with ADHD can be stressful, therefore obtaining reliable information is one of the most important parts of the treatment for this disorder. As pharmacists, we have the opportunity to give patients this information and help them make an informed decision about themselves, or their loved ones.

ADHD Awareness Month. Available: https://www.adhdawarenessmonth.org/

What is adhd? Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/adhd/facts.html. Published August 23, 2021. Accessed August 27, 2021.

About ADHD. CHADD. https://chadd.org/about/#history. Published July 13, 2021. Accessed September 20, 2021.

Articles

ADHD Awareness Months brings attention to a common, but still somewhat misunderstood condition that pharmacists encounter on a near daily basis.