1
|
Price A, Becker K, Ward JH, Ukoumunne OC, Gudka R, Salimi A, Mughal F, Melendez-Torres GJ, Smith JR, Newlove-Delgado T. Support for primary care prescribing for adult ADHD in England: national survey. Br J Gen Pract 2024:BJGP.2023.0595. [PMID: 38621804 DOI: 10.3399/bjgp.2023.0595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 04/09/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder, for which there are effective pharmacological treatments that improve symptoms and reduce complications. Guidelines published by the National Institute for Health and Care Excellence recommend that primary care practitioners prescribe medication for adult ADHD under shared-care agreements with Adult Mental Health Services (AMHS). However, provision remains uneven, with some practitioners reporting a lack of support. AIM This study aimed to describe elements of support, and their availability/use, in primary care prescribing for adult ADHD medication in England to improve access for this underserved population and inform service improvement. DESIGN AND SETTING Cross-sectional surveys were used to elicit data from commissioners, health professionals (HPs), and people with lived experience of ADHD (LE) across England about elements supporting pharmacological treatment of ADHD in primary care. METHOD Three interlinked cross-sectional surveys were used to ask every integrated care board in England (commissioners), along with convenience samples of HPs and LEs, about prescribing rates, AMHS availability, wait times, and shared-care agreement protocols/policies for the pharmacological treatment of ADHD in primary care. Descriptive analyses, percentages, and confidence intervals were used to summarise responses by stakeholder group. Variations in reported provision and practice were explored and displayed visually using mapping software. RESULTS Data from 782 responders (42 commissioners, 331 HPs, 409 LEs) revealed differences in reported provision by stakeholder group, including for prescribing (95% of HPs versus 64% of LEs). In all, >40% of responders reported extended AMHS wait times of ≥2 years. There was some variability by NHS region - for example, London had the lowest reported extended wait time (25%), while East of England had the highest (55%). CONCLUSION Elements supporting appropriate shared-care prescribing of ADHD medication via primary care are not universally available in England. Coordinated approaches are needed to address these gaps.
Collapse
Affiliation(s)
- Anna Price
- University of Exeter Medical School, Exeter
| | | | - John H Ward
- University of Exeter Medical School, Exeter, and Department of Psychiatry, University of Oxford, Oxford
| | - Obioha C Ukoumunne
- NIHR Applied Research Collaboration South West Peninsula, University of Exeter, Exeter
| | | | | | | | | | | | | |
Collapse
|
2
|
Ward J, McBride A, Gudka R, Becker K, Newlove-Delgado T, Price A. Wider health needs in attention deficit hyperactivity disorder from lived and professional experience: a qualitative framework analysis. BMJ Open 2024; 14:e083539. [PMID: 39153774 PMCID: PMC11331868 DOI: 10.1136/bmjopen-2023-083539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 07/26/2024] [Indexed: 08/19/2024] Open
Abstract
OBJECTIVES This study aimed to explore the perspectives of people with attention deficit hyperactivity disorder (ADHD), their supporters and primary care professionals (PCPs), on the wider physical and mental health needs of people with ADHD and the support currently available. DESIGN Qualitative semi-structured interviews, analysed using reflexive thematic analysis. SETTING Five general practice surgeries across England. PARTICIPANTS Participants with lived experience (people with ADHD and their supporters (n=11)) and PCPs (n=9) (eg, general practitioners and practice managers), recruited via clinical academic networks and previous work packages of this study. RESULTS We generated three major themes in relation to ADHD, using reflexive thematic analysis: understanding health, barriers to health and addressing health. Within these, participants reflected on mental and physical health challenges, as well as wider social difficulties and variability in support offered/accessed. CONCLUSIONS This study highlights that health problems in ADHD are complex and rooted both in individual factors (eg, mental health) and social factors (eg, support). This study also highlights the differences in expectations and fulfilment of healthcare.
Collapse
Affiliation(s)
- John Ward
- University of Exeter Medical School, Exeter, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
| | | | | | | | | | - Anna Price
- University of Exeter Medical School, Exeter, UK
| |
Collapse
|
3
|
Gudka R, Becker K, Ward J, Smith JR, Mughal F, Melendez-Torres GJ, Newlove-Delgado T, Price A. Primary care provision for young people with ADHD: a multi-perspective qualitative study. Br J Gen Pract 2024; 74:e408-e416. [PMID: 38316468 PMCID: PMC11080641 DOI: 10.3399/bjgp.2023.0626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 01/29/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Attention deficit hyperactivity disorder (ADHD) is a highly prevalent neurodevelopmental disorder. UK guidance states that primary care has a vital role in effective ADHD management, including referral, medication prescribing and monitoring, and providing broader mental health and wellbeing support. However, many GPs feel unsupported to provide health care for young people with ADHD. Inadequate health care is associated with rising costs for patients and society. AIM To investigate the experiences of young people with ADHD accessing primary care in England, from the perspectives of people with lived experience of ADHD and healthcare professionals (HCPs). DESIGN AND SETTING A qualitative study. Interviews were conducted with HCPs (GPs, practice managers, and a wellbeing worker) and people with lived experience of ADHD (young people aged 16-25 years and their supporters) located in integrated care systems across England. METHOD Semi-structured interviews were conducted with participants at five purposively selected general practices (varying by deprivation, ethnicity, and setting). Questions focused on experiences of accessing/providing health care for ADHD. Reflexive thematic analysis was undertaken within a critical realist framework to understand how provision works in practice and to explore potential improvements. RESULTS In total, 20 interviews were completed with 11 HCPs and nine people with lived experience. Three themes were generated: a system under stress, incompatibility between ADHD and the healthcare system, and strategies for change in ADHD primary care provision. CONCLUSION Standardisation of ADHD management in primary care, providing better information and support for HCPs, and advising on reasonable adjustments for people with lived experience could help improve access to effective treatments for young people living with ADHD.
Collapse
Affiliation(s)
- Rebecca Gudka
- University of Exeter Medical School, University of Exeter, Exeter
| | - Kieran Becker
- University of Exeter Medical School, University of Exeter, Exeter
| | - John Ward
- University of Exeter Medical School, University of Exeter, Exeter; Department of Psychiatry, University of Oxford, Oxford
| | - Jane R Smith
- University of Exeter Medical School, University of Exeter, Exeter
| | | | | | | | - Anna Price
- University of Exeter Medical School, University of Exeter, Exeter
| |
Collapse
|
4
|
Widding-Havneraas T, Markussen S, Elwert F, Lyhmann I, Bjelland I, Halmøy A, Chaulagain A, Ystrom E, Mykletun A, Zachrisson HD. Geographical variation in ADHD: do diagnoses reflect symptom levels? Eur Child Adolesc Psychiatry 2023; 32:1795-1803. [PMID: 35585272 PMCID: PMC10460326 DOI: 10.1007/s00787-022-01996-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 04/23/2022] [Indexed: 11/30/2022]
Abstract
Rates of ADHD diagnosis vary across regions in many countries. However, no prior study has investigated how much within-country geographic variation in ADHD diagnoses is explained by variation in ADHD symptom levels. We examine whether ADHD symptom levels explain variation in ADHD diagnoses among children and adolescents using nationwide survey and register data in Norway. Geographical variation in incidence of ADHD diagnosis was measured using Norwegian registry data from the child and adolescent mental health services for 2011-2016. Geographical variation in ADHD symptom levels in clinics' catchment areas was measured using data from the Norwegian mother, father and child cohort study for 2011-2016 (n = 39,850). Cross-sectional associations between ADHD symptom levels and the incidence of ADHD diagnoses were assessed with fractional response models. Geographical variation in ADHD diagnosis rates is much larger than what can be explained by geographical variation in ADHD symptoms levels. Treatment in the Norwegian child and adolescent mental health services is free, universally available upon referral, and practically without competition from the private sector. Factors beyond health care access and unequal symptom levels seem responsible for the geographical variation in ADHD diagnosis.
Collapse
Affiliation(s)
- Tarjei Widding-Havneraas
- Department of Clinical Medicine, University of Bergen, Jonas Lies Vei 87, 5021, Bergen, Norway.
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway.
| | | | - Felix Elwert
- Department of Sociology, University of Wisconsin-Madison, Madison, WI, USA
| | - Ingvild Lyhmann
- Department of Clinical Medicine, University of Bergen, Jonas Lies Vei 87, 5021, Bergen, Norway
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Ingvar Bjelland
- Department of Clinical Medicine, University of Bergen, Jonas Lies Vei 87, 5021, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Anne Halmøy
- Department of Clinical Medicine, University of Bergen, Jonas Lies Vei 87, 5021, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Ashmita Chaulagain
- Department of Clinical Medicine, University of Bergen, Jonas Lies Vei 87, 5021, Bergen, Norway
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Eivind Ystrom
- Promenta Research Center, Department of Psychology, University of Oslo, Oslo, Norway
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Arnstein Mykletun
- Centre for Research and Education in Forensic Psychiatry, Haukeland University Hospital, Bergen, Norway
- Division of Health Services, Norwegian Institute of Public Health, Oslo, Norway
- Department of Community Medicine, University of Tromsø, Tromsø, Norway
- Centre for Work and Mental Health, Nordland Hospital, Bodø, Norway
| | | |
Collapse
|
5
|
Jones B, Peri-Rotem N, Mountford-Zimdars A. Geographic opportunities for assisted reproduction: a study of regional variations in access to fertility treatment in England. HUM FERTIL 2023; 26:494-503. [PMID: 36964684 DOI: 10.1080/14647273.2023.2190040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 12/13/2022] [Indexed: 03/26/2023]
Abstract
It is estimated that one in seven couples in the UK experience infertility, though just over half of those affected by it seek professional help. Previous studies pointed to potential socioeconomic barriers in accessing assisted reproduction; however, less is known about geographic accessibility to fertility treatment and the way it is associated with measures of deprivation. In this study, we used publicly available data on fertility clinics, combined with official statistics for 315 local authorities in England, to create a standardized measure of geographic accessibility to fertility services. In addition, using a negative binomial regression model, we estimated the link between socioeconomic measures at the local authority level and availability of fertility services. We found that geographic accessibility to assisted reproduction is significantly higher in the most advantaged local authorities in terms of average household income and level of deprivation. This may lead to reduced opportunities for realizing fertility aspirations among those suffering from infertility in more deprived areas. Taking into account both socioeconomic and geographic barriers to accessing fertility treatment can contribute to a better understanding of help-seeking patterns for infertility, likelihood of achieving a live birth and inform policy to equalise opportunities in access to infertility treatment.
Collapse
Affiliation(s)
- Bobbie Jones
- Department of Computer Science, University of Exeter, Exeter, UK
| | - Nitzan Peri-Rotem
- Department of Sociology, Philosophy and Anthropology, University of Exeter, Exeter, UK
| | | |
Collapse
|
6
|
Scarpellini F, Bonati M. Transition care for adolescents and young adults with attention-deficit hyperactivity disorder (ADHD): A descriptive summary of qualitative evidence. Child Care Health Dev 2022; 49:431-443. [PMID: 36223008 DOI: 10.1111/cch.13070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 09/07/2022] [Accepted: 10/08/2022] [Indexed: 11/28/2022]
Abstract
The review presents a summary of available evidence about transition care of ADHD patients from all service users' perspectives. Common barriers, and suggestions for improvement ADHD of transition care, were extrapolated from qualitative research, including case notes studies, and were exposed. A comprehensive search of the PubMed, Embase, PsychInfo and Web of Science databases for articles published up to October 2021 was conducted to summarize recent evidence on the experiences of all stakeholders involved in the transition process. Reviews, other chronic conditions and different meaning of transition were excluded. Authors extracted data and assessed study quality independently. Findings were discussed taking into consideration barriers and suggestions from all service users' perspectives. Findings from 23 studies with different context and methods were collected and summarized. Most of the studies were conducted in UK, using interviews and questionnaires, and addressed to the physicians. The lack of information about ADHD as a condition and about transition process were the barriers most reported, while joint working and sharing transition protocols were the suggestions pointed out by all stakeholders. Despite different perspectives, all stakeholders exposed similar needs. The review reveals an evident need for defining and evaluating the effectiveness of transition programmes from child to adult ADHD services.
Collapse
Affiliation(s)
- Francesca Scarpellini
- Laboratory for Mother and Child Health, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Maurizio Bonati
- Laboratory for Mother and Child Health, Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| |
Collapse
|
7
|
Asherson P, Leaver L, Adamou M, Arif M, Askey G, Butler M, Cubbin S, Newlove-Delgado T, Kustow J, Lanham-Cook J, Findlay J, Maxwell J, Mason P, Read H, van Rensburg K, Müller-Sedgwick U, Sedgwick-Müller J, Skirrow C. Mainstreaming adult ADHD into primary care in the UK: guidance, practice, and best practice recommendations. BMC Psychiatry 2022; 22:640. [PMID: 36221085 PMCID: PMC9553294 DOI: 10.1186/s12888-022-04290-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 09/27/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND ADHD in adults is a common and debilitating neurodevelopmental mental health condition. Yet, diagnosis, clinical management and monitoring are frequently constrained by scarce resources, low capacity in specialist services and limited awareness or training in both primary and secondary care. As a result, many people with ADHD experience serious barriers in accessing the care they need. METHODS Professionals across primary, secondary, and tertiary care met to discuss adult ADHD clinical care in the United Kingdom. Discussions identified constraints in service provision, and service delivery models with potential to improve healthcare access and delivery. The group aimed to provide a roadmap for improving access to ADHD treatment, identifying avenues for improving provision under current constraints, and innovating provision in the longer-term. National Institute for Health and Care Excellence (NICE) guidelines were used as a benchmark in discussions. RESULTS The group identified three interrelated constraints. First, inconsistent interpretation of what constitutes a 'specialist' in the context of delivering ADHD care. Second, restriction of service delivery to limited capacity secondary or tertiary care services. Third, financial limitations or conflicts which reduce capacity and render transfer of care between healthcare sectors difficult. The group recommended the development of ADHD specialism within primary care, along with the transfer of routine and straightforward treatment monitoring to primary care services. Longer term, ADHD care pathways should be brought into line with those for other common mental health disorders, including treatment initiation by appropriately qualified clinicians in primary care, and referral to secondary mental health or tertiary services for more complex cases. Long-term plans in the NHS for more joined up and flexible provision, using a primary care network approach, could invest in developing shared ADHD specialist resources. CONCLUSIONS The relegation of adult ADHD diagnosis, treatment and monitoring to specialist tertiary and secondary services is at odds with its high prevalence and chronic course. To enable the cost-effective and at-scale access to ADHD treatment that is needed, general adult mental health and primary care must be empowered to play a key role in the delivery of quality services for adults with ADHD.
Collapse
Affiliation(s)
- Philip Asherson
- Social Genetic and Developmental Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, De Crespigny Park, London, SE5 8AF, UK.
| | | | | | | | - Gemma Askey
- NHS Warrington Clinical Commissioning Group, Warrington, UK
| | - Margi Butler
- NHS Warrington Clinical Commissioning Group, Warrington, UK
| | | | | | - James Kustow
- Barnet, Enfield and Haringey Mental Health NHS Trust, London, UK
| | | | - James Findlay
- NHS Northamptonshire Clinical Commissioning Group, Northampton, UK
| | | | - Peter Mason
- ADHD And Psychiatry Services Limited, Liverpool, UK
| | | | | | | | - Jane Sedgwick-Müller
- Social Genetic and Developmental Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, De Crespigny Park, London, SE5 8AF, UK
| | | |
Collapse
|
8
|
Young S, Asherson P, Lloyd T, Absoud M, Arif M, Colley WA, Cortese S, Cubbin S, Doyle N, Morua SD, Ferreira-Lay P, Gudjonsson G, Ivens V, Jarvis C, Lewis A, Mason P, Newlove-Delgado T, Pitts M, Read H, van Rensburg K, Zoritch B, Skirrow C. Failure of Healthcare Provision for Attention-Deficit/Hyperactivity Disorder in the United Kingdom: A Consensus Statement. Front Psychiatry 2021; 12:649399. [PMID: 33815178 PMCID: PMC8017218 DOI: 10.3389/fpsyt.2021.649399] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 02/24/2021] [Indexed: 12/12/2022] Open
Abstract
Background: Despite evidence-based national guidelines for ADHD in the United Kingdom (UK), ADHD is under-identified, under-diagnosed, and under-treated. Many seeking help for ADHD face prejudice, long waiting lists, and patchy or unavailable services, and are turning to service-user support groups and/or private healthcare for help. Methods: A group of UK experts representing clinical and healthcare providers from public and private healthcare, academia, ADHD patient groups, educational, and occupational specialists, met to discuss shortfalls in ADHD service provision in the UK. Discussions explored causes of under-diagnosis, examined biases operating across referral, diagnosis and treatment, together with recommendations for resolving these matters. Results: Cultural and structural barriers operate at all levels of the healthcare system, resulting in a de-prioritization of ADHD. Services for ADHD are insufficient in many regions, and problems with service provision have intensified as a result of the response to the COVID-19 pandemic. Research has established a range of adverse outcomes of untreated ADHD, and associated long-term personal, social, health and economic costs are high. The consensus group called for training of professionals who come into contact with people with ADHD, increased funding, commissioning and monitoring to improve service provision, and streamlined communication between health services to support better outcomes for people with ADHD. Conclusions: Evidence-based national clinical guidelines for ADHD are not being met. People with ADHD should have access to healthcare free from discrimination, and in line with their legal rights. UK Governments and clinical and regulatory bodies must act urgently on this important public health issue.
Collapse
Affiliation(s)
- Susan Young
- Psychology Services Limited, London, United Kingdom.,Department of Psychology, Reykjavik University, Reykjavik, Iceland.,ADHD Foundation, Liverpool, United Kingdom
| | - Philip Asherson
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, Kings College London, London, United Kingdom.,South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Tony Lloyd
- ADHD Foundation, Liverpool, United Kingdom
| | - Michael Absoud
- Department of Children's Neurosciences, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom.,King's Health Partners Academic Health Science Centre, London, United Kingdom.,Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom
| | - Muhammad Arif
- Leicestershire Partnership NHS Trust, Leicester, United Kingdom
| | | | - Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences & Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, United Kingdom.,Solent NHS Trust, Southampton, United Kingdom.,Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York, NY, United States
| | - Sally Cubbin
- The ADHD Clinic, Manor Hospital, Oxford, United Kingdom
| | - Nancy Doyle
- Genius Within, Plumpton Green, United Kingdom.,Department of Organizational Psychology, Birkbeck College, University of London, London, United Kingdom
| | - Susan Dunn Morua
- AADD-United Kingdom, Bristol, United Kingdom.,Bristol Adult ADHD Support Group, Bristol, United Kingdom
| | - Philip Ferreira-Lay
- Surrey and Borders Partnership NHS Foundation Trust, Leatherhead, United Kingdom
| | - Gisli Gudjonsson
- Department of Psychology, Reykjavik University, Reykjavik, Iceland.,Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | | | | | - Alexandra Lewis
- Cambridge & Peterborough NHS Foundation Trust, Cambridge, United Kingdom
| | - Peter Mason
- ADHD Foundation, Liverpool, United Kingdom.,ADHD and Psychiatry Services Limited, Liverpool, United Kingdom.,Cheshire and Wirral Partnership NHS Foundation Trust, Chester, United Kingdom
| | | | - Mark Pitts
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Helen Read
- ADHD Consultancy Limited, London, United Kingdom
| | - Kobus van Rensburg
- Adult ADHD and Asperger's Team & Children and Young People's ADHD and ASD Service, Northamptonshire Healthcare NHS Foundation Trust, Kettering, United Kingdom
| | - Bozhena Zoritch
- ADDmire Clinic, West Byfleet, United Kingdom.,Epsom and St. Helier University Hospital, Epsom, United Kingdom
| | - Caroline Skirrow
- Cambridge Cognition, Cambridge, United Kingdom.,Psychological Sciences, University of Bristol, Bristol, United Kingdom
| |
Collapse
|
9
|
Cortese S. Regional analysis of UK primary care prescribing and adult service referrals for young people with attention-deficit hyperactivity disorder: from little to very little. BJPsych Open 2020; 6:e43. [PMID: 32349851 PMCID: PMC7331081 DOI: 10.1192/bjo.2020.28] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Drawing on data from the Clinical Practice Research Datalink, Price et al reported UK regional variations in primary care prescribing and referral rates to adult mental health services for young people with attention-deficit hyperactivity disorder (ADHD) in transition from child and adolescent mental health services. Overall, considering that around 65% of young adults with childhood ADHD present with impairing ADHD symptoms and up to 90% of individuals with ADHD may benefit from ADHD medications, the study by Price et al shows that the rate of appropriate treatment for youngsters in the transition period varies from low to very low across the UK. As such, there is a continuous need for education and training for patients, their families, mental health professionals and commissioners, to eradicate the misconception that, in the majority of the cases, ADHD remits during adolescence and to support the devolvement of appropriate services for the evidence-based management of adult ADHD across the UK.
Collapse
Affiliation(s)
- Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, UK; Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, UK; Solent NHS Trust, UK; New York University Child Study Center, USA; and Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, UK
| |
Collapse
|