Principal Investigator: Brooke Molina, PhD
Funding Source: National Institute on Drug Abuse
The goal of this study was to better understand the management of ADHD in pediatric primary care. An important focus was training pediatricians and their office staff in clinical practice strategies that reduce risk for stimulant misuse and diversion while also addressing the needs of their patients. Across seven pediatric practices in the study, half of the practices were randomly assigned to receive training to aide this goal. The impact of the training on the patients and providers is the main outcome of the study, but given the importance of this study sample, many other variables were measured to improve understanding of ADHD experienced by teens treated in primary care.
Recognizing the value of stakeholder input, this project began with open discussions and interviews with pediatricians, advanced practice providers, teens and their parents, and other critical stakeholders as well as pilot work conducted previously with college student patients and their doctors. A provider workshop was refined for this age range and electronic surveys were written for administration before training and three times after at 6-month intervals.
We are pleased to report that participation rates were tremendous. All practices who were asked to participate agreed and, in the end, the study benefited from participation by 357 teenage patients, one of their parents each, and their providers with a greater-than 90% rate of follow-up participation over the three surveys.
In 2020, we published two sets of findings from the study's baseline (pre-training) data. These findings, now presented at multiple national and international meetings, have shown that:
Pediatricians were highly likely to report routine monitoring of symptoms and mental health among their patients, but they were less likely to be using strategies expected to reduce risk of stimulant diversion.
Pediatricians generally felt that they needed training in this area and that the topic was important to address.
Teenage patients prescribed stimulants for their ADHD had increasing risk for stimulant diversion as they aged toward adulthood, suggesting the importance of monitoring, and assisting with, risk management as patients age.
The main outcomes of the study (the impact of the training) are currently being prepared for publication and updates, along with other study results, are forthcoming!
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