Guidelines Improve Care for Children

The study intervenes with an entire community of primary care physicians and aims at helping them to diagnose more accurately and monitor treatment response of their patients with ADHD effectively. Although community practitioners are the first point of contact for children with ADHD, the use of standardised evidence-based diagnosis and treatment guidelines established by the American Academy of Pediatrics (AAP) was infrequent at most of the participating pediatric practices before the study began.

The intervention consisted of a training programme on how to implement AAP diagnosis and treatment guidelines. The training focused on modifying office systems to accommodate the AAP guidelines. This included building in the use of parent and teacher ADHD rating scales into the evaluation and treatment monitoring process.

After 84 Cincinnati-area community physicians finished training and implemented AAP guidelines at their practices, the use of ADHD child assessment rating scales by parents and teachers soared from 55 percent and 52 respectively to nearly 100 percent, the research team reported. This led to more accurate diagnosis of prospective patients and fewer children being started on medication inappropriately, they analysed. Systematic monitoring of patient medication response improved from a baseline of nine percent to over 40 percent. For patients who were being monitored systematically, most had documentation of significant symptom reduction during their first several months of treatment

"An additional benefit of the intervention is it appears that as a result of participating in the intervention, physicians in the community are now better equipped to recommend alternatives to medication – such as behavioural therapy – engage families in setting treatment goals, and more effectively coordinate care with the child's school." said Doctor Jeff Epstein, lead author of the study.

MEDICA.de; Source: Cincinnati Children's Hospital Medical Center