Counseling Points - January 2009 - (Page 15)

Counseling Points™: Program Evaluation Form Caring for Individuals with ADHD Throughout the Lifespan: Pharmacologic Treatment Strategies for Children, Adolescents, and Adults with ADHD Please mail or fax the completed form to NAPNAP, 20 Brace Road, Suite 200, Cherry Hill, NJ 08034-2634, Fax 856-857-1600. There is no fee for this educational activity but you must complete this form to receive acknowledgement for the activity. 1 = Strongly Disagree 2 = Disagree 3 = Somewhat Disagree 4 = Somewhat Agree 5 = Agree 6 = Strongly Agree Ì No Did you participate in the preassessment survey? Ì Yes To what extent do you agree with the following statements? (Please circle the appropriate number on the scale.) 1. No treatment has been found to cure attention deficit hyperactivity disorder (ADHD), but there are a number of pharmacologic interventions that have been demonstrated to manage symptoms effectively. 1 2 3 4 5 6 2. The primary goal of pharmacologic treatment for children and adolescents with ADHD is to reduce disruptive behaviors, better relationships with others, and otherwise improve social functioning 1 2 3 4 5 6 3. Stimulants are the first-line treatments for ADHD in children, adolescents, and adults. 1 2 3 4 5 6 4. There is adequate research and agreed-upon guidelines to support evidence-based practice of ADHD in adults 1 2 3 4 5 6 To what extend were the following objectives satisfied? 5. List the major categories of pharmacologic agents used in the treatment of children, adolescents, and adults with attention deficit hyperactivity disorder (ADHD). 1 2 3 4 5 6 6. Describe the pharmacokinetics, indications, contraindications, and adverse events associated with these pharmacologic agents 1 2 3 4 5 6 7. State recommendations for drug titration, structured treatment interruptions, and drug abuse in children, adolescents and adults with ADHD 1 2 3 4 5 6 To what extent was the content well-organized? 8. List the major categories of pharmacologic agents used in the treatment of children, adolescents, and adults with attention deficit hyperactivity disorder (ADHD). 1 2 3 4 5 6 9. Describe the pharmacokinetics, indications, contraindications, and adverse events associated with these pharmacologic agents 1 2 3 4 5 6 10. State recommendations for drug titration, structured treatment interruptions, and drug abuse in children, adolescents and adults with ADHD. ..1 2 3 4 5 6 To what extent was the content easily understandable? 11. List the major categories of pharmacologic agents used in the treatment of children, adolescents, and adults with attention deficit hyperactivity disorder (ADHD). 1 2 3 4 5 6 12. Describe the pharmacokinetics, indications, contraindications, and adverse events associated with these pharmacologic agents. 1 2 3 4 5 6 13. State recommendations for drug titration, structured treatment interruptions, and drug abuse in children, adolescents and adults with ADHD 1 2 3 4 5 6 General Comments 17.The topic was current and relevant to my area of professional interest. 1 2 3 4 5 6 18.The program was free of commercial bias. 1 2 3 4 5 6 19.The program increased my awareness and understanding of the subject matter. 1 2 3 4 5 6 20.As a result of this continuing education activity (check only one): Ì I will modify my practice. Ì I will wait for more information before modifying my practice. Ì The program reinforces my current practice. Suggestions for future topics/additional comments: Follow-up As part of our continuous quality improvement effort, we conduct post-activity follow-up surveys to assess the impact of our educational interventions on professional practice. Please check one: Ì Yes, I would be interested in participating in a follow-up survey. Ì No, I would not be interested in participating in a follow-up survey. Patient Education Follow-up Would you be interested in receiving an educational magazine on ADHD to distribute to your patients? 1 2 3 4 5 6 Posttest Answer Key A10-09-E01 Request for Credit Name Type of Degree Organization Specialty Address City State ZIP Phone Fax E-mail Signature Date Ì Yes 7 Ì No 8 9 10 Fax form to 856-857-1600 15 JANUARY 2009

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Counseling Points - January 2009

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