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Provision of brief paediatrician training and computer-assisted medication management does not improve symptoms in children with ADHD

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Question

Question

Does provision of brief physician training and computer-assisted medicine management improve symptoms in children with attention-deficit hyperactivity disorder (ADHD) compared with treatment as usual (TAU)?

Patients

270 children (77% boys; age range 5.9–11.11 years; mean age 8.2 years) with ADHD diagnosed according to DSM-V criteria (combined type: 49%, hyperactive/impulsive type: 9.8% and inattentive type: 41.2%) and attending participating paediatric practices. Main exclusions: taking an antipsychotic or medication for ADHD in the previous 2 months; intolerance to stimulants or taking medication not compatible with stimulants; not living with their primary care giver for the previous 6 months; an IQ<70 or attending classes for children with intellectual disabilities; an autistic spectrum disorder, chronic tics or Tourette syndrome; suicidal ideation; or any major illness.

Setting

24 paediatric practices in Chicago (21 private practices and 3 practices serving low-income families); 2003–2009.

Intervention

Specialised care (SC) (n=137) or TAU (n=133). SC included 2 h of physician training in a guideline-based ADHD medication management protocol for stimulant medications and atomoxetine and 1 h training for office staff on using an ADHD medication management computer program (the Focus program) for monitoring and guiding medication titration. The SC package also …

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