Opportunity was a main barrier for both groups, who reported lack of time and the absence of educational material about drug holidays. Capability, in terms of knowledge and skills, was not a barrier identified for CAMHS practitioners but was for GPs. Multiple barriers to practitioner engagement in planned drug holidays from methylphenidate were identified. Possible interventions for increasing prescribers’ engagement with planned drug holidays were considered in response. Transcripts were analysed qualitatively against the components of the Capability–Opportunity–Motivation–Behaviour (COM-B) model. Interviews with 8 general practitioners (GPs) and 8 Child and Adolescent Mental Health Service (CAMHS) practitioners were conducted. Practitioners involved in shared-care prescribing for children and adolescents with ADHD in one UK County were included. The aim of this study was to identify what stops practitioners from routinely discussing planned drug holidays from methylphenidate with children, adolescents, and their parents. There is little evidence of planned, practitioner-initiated drug holidays from methylphenidate. However, drug holidays are reactively initiated by families, or recommended by practitioners if growth has been suppressed by medication rather than proactively to check the need. National and international guidelines on the treatment of attention deficit hyperactivity disorder (ADHD) in children and adolescents call for annual reviews to assess continuing need for medication by considering brief periods without medication, referred to as ‘Drug holidays’.
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