Treatment Preferences in Attention Deficit Hyperactivity Disorder: A Systematic Review of Discrete Choice Experiment and Best-Worst Scaling Studies

Astratt

Background: Attention deficit hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder that affects both children and adults, impacting academic, social, and emotional functioning. Medication adherence remains a significant challenge in ADHD treatment. Discrete choice experiments (DCE) and best-worst scaling (BWS) are increasingly used to assess treatment preferences, yet their application to ADHD treatment is underexplored. Objectives: This systematic review aims to evaluate treatment preferences among ADHD caregivers and adult patients, assess methodological limitations, and identify research gaps in existing literature grounded in DCE and BWS methodologies. Methods: A systematic search was conducted across PubMed, Web of Science, and other databases from database inception to June 1, 2025. Studies using DCE, BWS, or conjoint analysis methods to assess ADHD treatment preferences were included. Data extraction focused on study characteristics, participant profiles, and preference outcomes, and quality was assessed using the PREFS framework. Results: Fifteen studies were included, with a predominant focus on medication attributes. The most important attributes identified were symptom control, severity of side effects, and social support. Preferences varied by age and treatment stage, with adults showing higher tolerance for side effects compared to caregivers of children. Economic cost was a lower priority compared to treatment outcomes and social support. Conclusions: ADHD treatment preferences are diverse, influenced by multiple factors including age, disease stage, and treatment side effects. These findings highlight the need for patient-centered treatment strategies. Future research should address methodological gaps, expand investigation into preferences for behavioral interventions, employ longitudinal studies, and explore diverse populations to improve the applicability of preference research across cultural and economic contexts.