New Survey Shows Fear of Medication, Confusing Information Keep Children With Attention Deficit/Hyperactivity Disorder from Getting Treatment

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National Hotline, 1-888-ASK-ADHD, Brings Together Top ADHD Experts To Fight Misconceptions About the Disorder

Nine in 10 physicians, teachers, and parents of children with attention deficit/hyperactivity disorder (ADHD) believe that left untreated, ADHD can have serious effects on children's performance in school and relationships with family and friends, according to a new set of Harris Interactive surveys released today. Yet more than four out of five survey respondents said that apprehension about medication and parents' lack of reliable information often prevent children with ADHD from getting the treatment they need to succeed in school and life.

When ADHD goes untreated, it can have consequences into adulthood. Harris Interactive also surveyed adults with ADHD: 92 percent of those who were not treated until they were adults said they wished they had been treated for the disorder as children.

"ADHD Experts On Call is an easy way for people to obtain quick, credible information on a condition that can be confusing and frustrating for those it affects," said Dr. Andrew Adesman, chief of the Division of Developmental and Behavioral Pediatrics at Schneider Children's Hospital in New Hyde Park, N.Y. "While this hotline is available to anyone who has questions about ADHD, it may be especially beneficial for parents and teachers who may start to see signs of the disorder at the beginning of the school year -- a time when referrals for diagnoses of ADHD often are made," added Dr. Adesman, who will participate in the program for the second time.

"I have seen with my own eyes the pain that ADHD can cause," said Catherine Hicks, mother of television's 7th Heaven family. "I urge parents to take advantage of the opportunity Shire Richwood has created by calling 1-888-ASK-ADHD for expert advice about ADHD."

Survey findings highlight need for improved diagnosis of ADHD The new Harris Interactive surveys, sponsored by Shire Richwood, are the first to probe the perceptions about ADHD and its treatment among such a broad and diverse audience, which includes child psychiatrists, psychiatrists, pediatricians, teachers, parents and grandparents of children with ADHD, adults with ADHD, as well as the general public.

While the surveys reveal widespread agreement that many factors prevent people diagnosed with ADHD from getting appropriate treatment, they also show that on average, child psychiatrists and psychiatrists think only half of all children who have ADHD are actually being diagnosed with the condition. Pediatricians think only six in 10 children (63%) with the disorder are being diagnosed, leaving almost four in 10 without a diagnosis.

"These findings are consistent with what the data show -- that ADHD is underdiagnosed and undertreated and not the reverse," commented Dr. Peter Jensen, Director of the Center for the Advancement of Children's Mental Health at Columbia University in New York, and a participant in ADHD Experts On Call. In addition to a perception of underdiagnosis, all three groups of physicians treating ADHD think one in four children diagnosed with ADHD either is misdiagnosed or does not actually have ADHD (25 percent, 25 percent, and 23 percent for child psychiatrists, psychiatrists and pediatricians, respectively). For their part, fifty-seven percent (57%) of teachers surveyed think children are "sometimes" misdiagnosed and treated for ADHD when they actually have some other condition. While adults with ADHD consider underdiagnosis as an issue (three out of four (77%) think the condition is underdiagnosed in adults), they also are concerned about misdiagnosis. One in four (26%) says that adults are "very often" or "often" diagnosed and treated for ADHD when they actually have some other condition, and more than half (53%) say that adults are "very often" or "often" diagnosed and treated for some other condition when they actually have ADHD.

When asked whether physicians agree on the symptoms and diagnosis of ADHD, a majority of physicians say yes (68%, 58%, and 74% for child psychiatrists, psychiatrists, and pediatricians, respectively), but a sizable minority does not think that physicians agree (31%, 41%, and 24%, respectively).

"As the manufacturer of a medication that treats ADHD, we cannot stress enough how important an accurate diagnosis is, because a proper diagnosis leads to appropriate treatment. Because there is no single test to diagnose ADHD, the diagnostic guidelines recently released by the American Academy of Pediatrics are an important step to help ensure that people with this condition are properly diagnosed and then receive the appropriate treatment regimen," said Stefan Antonsson, senior vice president for marketing at Shire Richwood.

The surveys also found that:

Virtually all doctors, teachers, and parents of children with ADHD interviewed said that left untreated, ADHD has serious effects on children's performance in school (99%, 95%, and 98%, respectively), family life (98%, 89%, and 87%, respectively), and social skills (98%, 90%, and 92%, respectively).
The vast majority of doctors, teachers, and parents of children with ADHD interviewed said that lack of information (84%, 83%, and 94%, respectively), parent's fear of medication (84%, 83%, and 90%, respectively), and the stigma of medication (83%, 72%, and 85%, respectively) prevent many children with ADHD from getting appropriate treatment.
Among adults with ADHD, the findings were similar. Ninety percent said that lack of information keeps many adults with ADHD from getting treatment, 80% said confusing media reports, 74% the stigma of medication, 73% fear of medication, and 67% the overall controversy.
The overwhelming majority (92%) of adults with ADHD who were first treated for the disorder at age 18 or above wish they had been treated for ADHD as children.
Adults with ADHD agreed that left untreated, ADHD has serious effects on their ability to accomplish tasks (93%), performance at work (85%), career development (83%), self-esteem (82%), social skills (74%), relationships with family members (74%), and relationships with co-workers (70%).
Nearly all parents of children with ADHD (92%) and nine in 10 teachers surveyed (92%) agree that medication is a successful treatment for children with ADHD. Nearly all adults with ADHD (90%) agree that medication is effective at controlling their ADHD.
Virtually all doctors surveyed (95%) agree that most children with ADHD would benefit from being treated with medication.
The survey showed that for some patients, side effects from ADHD medications are a concern. Two in 10 child psychiatrists, psychiatrists, and pediatricians (27%, 26%, and 22%, respectively) think that the side effects are "somewhat serious," while 47% of parents and grandparents consider them so. Very few (2%) doctors consider medication side effects to be "very serious" in general, while 16% of parents and grandparents of children or grandchildren with ADHD perceive them as such. But the majority of doctors (69%, 72%, and 76% for child psychiatrists, psychiatrists, and pediatricians, respectively) think the side effects are either "not very serious" or "not serious at all."
The doctors surveyed think that up to one-half of children with ADHD are not actually diagnosed with the condition (between 37% and 51% of children according to the three groups of physicians surveyed); one in five (21%) of parents and grandparents of children with ADHD thinks it is underdiagnosed in school-age children. Two-thirds of the latter group (64%) thinks it is overdiagnosed in school-age children. On the other hand, three in four adults with ADHD (77%) think ADHD is underdiagnosed in adults in general.

"The results of these surveys underscore the gravity of ADHD and remind us that the problems associated with it do not go away. The risk of failing to treat a disorder such as ADHD is too great to overlook," said Dr. Jensen. "ADHD Experts On Call should afford participants and opportunity to cut through the stigma of ADHD diagnosis and treatment and give children and adults with ADHD every chance to succeed."

About ADHD

ADHD is considered the most commonly diagnosed psychiatric disorder among children. Children with ADHD often are inattentive, impulsive, and hyperactive -- difficulties serious enough to interfere with their ability to function normally in academic or social settings. In addition, up to 66 percent of children with ADHD will continue to show symptoms into adulthood.

ADHD usually can be successfully managed with a combination of treatments, including educational approaches, psychological and behavioral therapies, and medications. One medication that is used as part of a combination treatment regimen is Adderall(R) (mixed salts of a single-entity amphetamine product).* In fact, doctors are increasingly prescribing Adderall as part of multi-modal treatment programs. It has been shown to improve attention span and decrease distractibility, impulsivity, and hyperactivity -- and often does not have to be taken in school.

Adderall is generally well-tolerated -- adverse reactions have seldom been reported (the most frequently reported adverse reactions include anorexia, insomnia, stomach pain, headache, irritability, and weight loss). Although there is no "cure" for ADHD, physicians, parents, teachers, nurses, and advocates are finding ways to help people with the condition learn to adapt to their academic, social, and work settings.

Shire Richwood
Shire Richwood is a subsidiary of Shire Pharmaceuticals Group plc, an international specialty pharmaceutical company with a strategic focus on four therapeutic areas: central nervous system disorders, oncology, gastroenterology, and metabolic diseases. The group has a sales and marketing infrastructure with a broad portfolio of products targeting the US, Canada, UK, Republic of Ireland, France, Germany, Italy, and Spain, with plans to add Japan by 2004.

Shire's principal CNS products include Adderall(R) (mixed salts of a single-entity amphetamine product) and Dextrostat(R) (dextroamphetamine sulfate) for the treatment of ADHD and narcolepsy, and Carbatrol(R) (carbamazepine extended-release capsules) for the treatment of partial seizures with complex symptomatology, generalized tonic-clonic seizures and mixed seizures. Reminyl(TM) (galantamine), a new treatment for Alzheimer's disease, is being developed by the Janssen Research Foundation and Shire under a co-development and licensing agreement. Reminyl has received an "FDA approvable" letter and Janssen is in the process of amending and providing additional information to the NDA regulatory application to obtain final FDA approval for marketing and distribution in the United States.

* For full prescribing information on Adderall, please call 1-800-536-7878

Harris Interactive Survey Methodology

Teacher Survey
500 interviews were conducted by telephone with teachers in the United States between May 1 and June 9, 2000. Teachers in both public and private schools were interviewed. Participation in the study was limited to teachers who teach at least part-time in the classroom, teach grade(s) 1 through 12, and have had a student in their class who was diagnosed with ADHD.

Adult and Parent/Grandparent Survey
523 interviews were conducted online with adults diagnosed with ADHD, and 755 interviews were conducted online with parents and grandparents of children diagnosed with ADHD, between June 13 and June 26, 2000. Participation for parents and grandparents was limited to parents and grandparents of children under 18 years of age who have been diagnosed with ADHD. Participation for grandparents was limited to grandparents who live in the same household as a grandchild diagnosed with ADHD.

"Public" Survey
1007 interviews were conducted by telephone with a cross section of U.S. adults between May 4 and May 8, 2000. Figures for age, sex, race, education, number of adults, and number of voice/telephone lines in the household were weighted where necessary to reflect actual proportions within the general population.

Physician Survey
200 interviews were conducted by telephone with child psychiatrists, 200 were conducted with psychiatrists, and 200 were conducted with pediatricians between February 24 and April 4, 2000. Physicians were screened to ensure that they actively see patients and have seen a minimum of 10 patients in the past year who have been diagnosed with ADHD. In addition, psychiatrists and pediatricians were required to have written at least 120 prescriptions for ADHD medication in the past year (corresponding to at least ten patients with ADHD).

Margin of Error
The margin of error -- at the 95% confidence level for each of the sample groups -- is as follows: +/- 3% for the "public", +/- 4% teachers, +/- 4% for adults, parents and grandparents, and +/- 7% for child psychiatrists, psychiatrists, and pediatricians.

CONTACT: Shire Richwood

Sept. 11, 2000

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