Susan Nguyen, a Sydney pharmacy co-owner and founder of ADHD Support Pharmacist, has told AJP Podcast host Carlene McMaugh that she hopes pharmacists will try to gain a better understanding of Attention Deficit/Hyperactivity Disorder and consider how it affects patients’ lives in multiple ways – including its comorbidities, and what pharmacists can do to help.
She likens it to diabetes in the way that people make negative judgements about a patient’s behaviour – but also contrasts it with regard to the lack of a holistic approach.
“When you look at someone who has diabetes, they experience the judgement, ‘oh, they’ve got diabetes. Oh, they must have been having too much sugar or too many soft drinks. Or their parents probably gave them lollies every day’,” she says.
But even with this wider social stigma, pharmacists do not generally hold negative opinions about people with diabetes, she says, and do consider the wider picture.
“You’re thinking of foot care, wound care, vaccinations, diabetes med checks… diabetes has a lot of, I guess, comorbidities and other conditions and lifestyle factors played as well.
“When you look at ADHD, it’s a lot, just much the same. You’re looking at a lot of comorbidities, you’re looking at lifestyle, you’re looking at complications, you’re looking at as well, the stigma…
“When you care for someone with ADHD and you delve into it more, you start to see there’s anxiety, there’s depression, there’s also [that] unmanaged ADHD means they may be eating, there could be obesity there, drug use work, relationship problems, a whole gamut.
“So it’s where pharmacists need to be.”
Nguyen also looks into misconceptions such as overdiagnosis, that ADHD is a condition mainly affecting boys, and that ADHD medicines may impact quality of life.
And significantly, she speaks about how people with ADHD are judged negatively for their own symptoms.
“The lack of concentration, the disorganisation, the time blindness, not being able to manage your scripts, not getting your scripts.
“It goes out of date, you freak out, the patient rings up and they say, ‘look, I haven’t got any of my medications left’.
“When we hear that it could be easily seen as they’re being lazy, they’ve been so they’ve let themselves down to let us down.
“It’s such a hassle. It’s inconvenient, but it’s the presenting symptom, and they’re stigmatised for their presenting symptoms.
“We’re actually, as healthcare professionals, as pharmacists, as even as society, we’re almost punishing people with ADHD for what they have, whereas someone with diabetes, they might have more UTIs, they might have infections that just don’t heal, that sort of stuff.
“But there’s a lot of support. And that’s because we look at the symptoms, we understand the pathophysiological side, but because of that lack of, I guess, understanding of ADHD, it’s become more of about a character flaw or character trait.
“And so that really makes it hard for, I guess, healthcare professionals to show that care and support.
“And I feel that this is where we need to really, as pharmacists making that stance on that and then supporting our patients in a much better way.”
01:21 – Why does ADHD need more attention in pharmacy?
04:18 – The comparison with diabetes
07:14 – ADHD in women and inattentive symptoms
08:11 – The role of social media
12:26 – Will medication “fix it up”?
14:04 – How can we widen our views?
16:32 – “With stimulant prescribing, it is hard.”
18:10 – The consequences of unmanaged ADHD
20:44 – How do we share information?
21:49 – “Pharmacists may think, oh, they’re going to get tolerant when they take Ritalin for so long.”
23:10 – “If you’ve seen a patient who comes in with their prescription for Vyvanse, we can’t assume that, hey, everything’s under control.”
26:27 – The carer’s perspective
28:37 – Pharmacists with ADHD
32:39 – “We need more pharmacists to really be in that space to advocate for patients.”
You can access the full transcript of this podcast here. While we endeavour to ensure all important words and phrases are correct, please note there may be some minor inaccuracies in the transcription.
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Carlene McMaugh
