Typical ADHD Care Leaves Room for Improvement
Many pediatricians fail to follow guidelines for diagnosis, treatment, and follow-up
MONDAY, Nov. 3, 2014 (HealthDay News) -- Many community-based pediatricians do not follow guideline-recommended care for children with attention-deficit/hyperactivity disorder (ADHD), according to a new study published online Nov. 3 in Pediatrics.
Researchers reviewed ADHD care by reviewing 1,594 patient charts at random from 188 pediatric health care providers at 50 practices in central and northern Ohio.
While 93.4 percent of ADHD children take medication, only 13 percent receive some form of psychosocial therapy as well, the researchers noted. Among children prescribed medication for ADHD, only 47.4 percent had follow-up with the pediatrician within 30 days. Only 10.8 percent of patient charts contained a parent's rating of ADHD symptoms within the first year of treatment, and only 7.5 percent had any rating of symptoms from teachers. Nearly half the time, pediatricians also did not gather these behavioral rating scales from parents and teachers before diagnosing a child with ADHD. In approximately 30 percent of cases, pediatricians did not document use of the Diagnostic and Statistical Manual of Mental Disorders criteria.
"The quality of care seems to be very low and not in accord with American Academy of Pediatrics guidelines," lead author Jeffery Epstein, Ph.D., director of the Center for ADHD, Behavioral Medicine and Clinical Psychology at Cincinnati Children's Hospital, told HealthDay.