Post by franksmom on Dec 28, 2004 21:59:14 GMT -5
Pediatric Patients Get Poor Follow-Up After ADHD Diagnosis
By Anne Harding
NEW YORK (Reuters Health) Dec 21 - Children with attention deficit-hyperactivity disorder (ADHD) who are prescribed stimulant medication rarely receive optimal follow-up care, the results of a new study suggest.
A survey of 659 children ages 4 to 15 found that in the 6 months after an ADHD diagnosis, the median number of follow-up visits was one. Children who had been prescribed medication -- 78% of the total -- were no more likely to have received follow-up care than children who had not. Just 26% of the patients in the study saw a mental health specialist for follow-up.
"This is too few visits to permit adjustment of medication or support adherence to treatment," Dr. William Gardner of the Children's Research Institute of Ohio State University in Columbus and colleagues write in the December issue of The Journal of Pediatrics.
"The AAP Guideline for the treatment of ADHD says that immediately after diagnosis, families should be in contact with their doctor frequently until the child is stable and proper dosage has been established," Dr. Gardner told Reuters Health. "'Frequently' can mean up to once a week. After the child is stable, follow-up visits should occur every 3 to 6 months to monitor treatment."
Dr. Gardner said he believes the findings, which employed data from a large sample of pediatric practices across the country, represent fairly typical care received by a child after an ADHD diagnosis.
Black children, as well as those on Medicaid, were more likely to see a mental health specialist, as were children with more internalizing symptoms. The researchers also found that primary care clinicians who had received fellowship training in mental health provided better follow-up care than those who had not.
But better training for primary care physicians is not likely to be enough to improve follow-up care for ADHD patients, Dr. Gardner and his colleagues note.
"We would urge primary clinicians to establish office systems that would promote follow-up visits by families; for example, a system that prompted a nurse or social worker to call a family a week or two after the diagnosis if they haven't had a return visit," Dr. Gardner suggested. "The call could assess the child's symptoms, find out whether a prescription has been filled [and] whether the medication is being taken."
Based on the study findings, Dr. Gardner's group concludes that systematic efforts to improve the quality of care for children with ADHD are warranted.
J Pediatr 2004;145:767-771.
By Anne Harding
NEW YORK (Reuters Health) Dec 21 - Children with attention deficit-hyperactivity disorder (ADHD) who are prescribed stimulant medication rarely receive optimal follow-up care, the results of a new study suggest.
A survey of 659 children ages 4 to 15 found that in the 6 months after an ADHD diagnosis, the median number of follow-up visits was one. Children who had been prescribed medication -- 78% of the total -- were no more likely to have received follow-up care than children who had not. Just 26% of the patients in the study saw a mental health specialist for follow-up.
"This is too few visits to permit adjustment of medication or support adherence to treatment," Dr. William Gardner of the Children's Research Institute of Ohio State University in Columbus and colleagues write in the December issue of The Journal of Pediatrics.
"The AAP Guideline for the treatment of ADHD says that immediately after diagnosis, families should be in contact with their doctor frequently until the child is stable and proper dosage has been established," Dr. Gardner told Reuters Health. "'Frequently' can mean up to once a week. After the child is stable, follow-up visits should occur every 3 to 6 months to monitor treatment."
Dr. Gardner said he believes the findings, which employed data from a large sample of pediatric practices across the country, represent fairly typical care received by a child after an ADHD diagnosis.
Black children, as well as those on Medicaid, were more likely to see a mental health specialist, as were children with more internalizing symptoms. The researchers also found that primary care clinicians who had received fellowship training in mental health provided better follow-up care than those who had not.
But better training for primary care physicians is not likely to be enough to improve follow-up care for ADHD patients, Dr. Gardner and his colleagues note.
"We would urge primary clinicians to establish office systems that would promote follow-up visits by families; for example, a system that prompted a nurse or social worker to call a family a week or two after the diagnosis if they haven't had a return visit," Dr. Gardner suggested. "The call could assess the child's symptoms, find out whether a prescription has been filled [and] whether the medication is being taken."
Based on the study findings, Dr. Gardner's group concludes that systematic efforts to improve the quality of care for children with ADHD are warranted.
J Pediatr 2004;145:767-771.
. I love my son's dr and she takes the time to sit and listen to what has happened over the last 6 months. Ds is one of the first patients in her office to be on strattera (2 yrs. in Jan.) and she is always interested in what has happened. One thing---if we don't go for our 6 month med check then we don't get anymore scripts for med so we really don't have a choice but I wouldn't want it any other way 
much easier to keep everything in check! 
