Care Provision and Prescribing Practices of Physicians Treating Children and Adolescents With ADHD

Patel, Ayush; Medhekar, Rohan; Ochoa-Perez, Melissa; Aparasu, Rajender R.; Chan, Wenyaw; Sherer, Jeffrey T.; Alonzo, Joy; Chen, Hua

doi:10.1176/appi.ps.201600130

Cited by 28 publications

(21 citation statements)

References 22 publications

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“…Provider availability may be a key driver, because few trained professionals are available to deliver evidence-based psychosocial treatments for children (15). There may be differences by physician type in care of children with ADHD (30). Physicians may prescribe medication while families are placed on waiting lists for psychological services (15, 31, 32).…”

Section: Discussionmentioning

confidence: 99%

Adherence to Recommended Care Guidelines in the Treatment of Preschool-Age Medicaid-Enrolled Children With a Diagnosis of ADHD

Morán

Serban

Danielson

et al. 2019

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Objective: Attention-deficit/hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder of childhood. Clinical guidelines recommend behavior therapy as the first-line treatment for preschool-age children with ADHD. This study evaluated longitudinal patterns of services received by Medicaid-enrolled children ages 2 to 5 with ADHD in seven southeastern states (Alabama, Florida, Georgia, Louisiana, Mississippi, North Carolina, and South Carolina). Methods: A discrete sequence clustering analysis was used with 2005–2012 Medicaid Analytic eXtract data to profile patient-level utilization for each state, with a focus on receipt of psychological services and medication. The model output was used to assess utilization behaviors longitudinally relative to recommended care guidelines and to characterize sources of variation in utilization patterns by demographic and ecological factors. Results: Five states had a utilization profile with a high probability of receipt of psychological services before medication among children with ADHD, covering 16% of the total study population. Most young children’s ADHD care experience in the seven states (65%) fit utilization profiles characterized by a high probability of receiving any ADHD medication. Black race was significantly associated with higher utilization of psychological services in three states. Conclusions: About 16% of Medicaid-enrolled preschool-age children with ADHD received care during 2005–2012 that appeared to be consistent with 2011 recommended care guidelines. State-level and subpopulation variations in utilization for ADHD-related clinical care were found. The findings indicate that there were major gaps in treatment for ADHD among young children and that the gaps are wider for some states and subpopulations of children.

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Section: Discussionmentioning

confidence: 99%

Adherence to Recommended Care Guidelines in the Treatment of Preschool-Age Medicaid-Enrolled Children With a Diagnosis of ADHD

Morán

Serban

Danielson

et al. 2019

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“…Firstly, the loss of daily routine and the lack of interpersonal and social interaction could work as potential risk factors for mental health problems or could worsen ADHD symptoms. In addition, majority of the ADHD children receive care from primary care settings (Patel et al, 2017; Subcommittee on Attention-Deficit/ Hyperactivity et al, 2011). Children with ADHD could not get timely and professional care from home setting.…”

Section: Introductionmentioning

confidence: 99%

Acute stress, behavioural symptoms and mood states among school-age children with attention-deficit/hyperactive disorder during the COVID-19 outbreak

Zhang

Shuai

et al. 2020

Asian Journal of Psychiatry

280

292

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Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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“…The CEMR database has been extensively used for health outcome academic research worldwide in the fields of diabetes [ 21 - 26 ], cardiovascular research [ 27 - 31 ], obesity [ 32 - 34 ], inflammatory diseases [ 35 - 38 ], mental health [ 39 - 41 ], and other diseases [ 42 , 43 ]. To draw meaningful inferences from such studies and to generalize the results, it is essential to understand the underlying population.…”

Section: Introductionmentioning

confidence: 99%

Evaluating the Representativeness of US Centricity Electronic Medical Records With Reports From the Centers for Disease Control and Prevention: Comparative Study on Office Visits and Cardiometabolic Conditions

Montvida¹,

Dibato²,

Paul³

2020

JMIR Med Inform

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Background Electronic medical record (EMR)–based clinical and epidemiological research has dramatically increased over the last decade, although establishing the generalizability of such big databases for conducting epidemiological studies has been an ongoing challenge. To draw meaningful inferences from such studies, it is essential to fully understand the characteristics of the underlying population and potential biases in EMRs. Objective This study aimed to assess the generalizability and representativity of the widely used US Centricity Electronic Medical Record (CEMR), a primary and ambulatory care EMR for population health research, using data from the National Ambulatory Medical Care Surveys (NAMCS) and the National Health and Nutrition Examination Surveys (NHANES). Methods The number of office visits reported in the NAMCS, designed to meet the need for objective and reliable information about the provision and the use of ambulatory medical care services, was compared with similar data from the CEMR. The distribution of major cardiometabolic diseases in the NHANES, designed to assess the health and nutritional status of adults and children in the United States, was compared with similar data from the CEMR. Results Gender and ethnicity distributions were similar between the NAMCS and the CEMR. Younger patients (aged <15 years) were underrepresented in the CEMR compared with the NAMCS. The number of office visits per 100 persons per year was similar: 277.9 (95% CI 259.3-296.5) in the NAMCS and 284.6 (95% CI 284.4-284.7) in the CEMR. However, the number of visits for males was significantly higher in the CEMR (CEMR: 270.8 and NAMCS: 239.0). West and South regions were underrepresented and overrepresented, respectively, in the CEMR. The overall prevalence of diabetes along with age and gender distribution was similar in the CEMR and the NHANES: overall prevalence, 10.1% and 9.7%; male, 11.5% and 10.8%; female, 9.1% and 8.8%; age 20 to 40 years, 2.5% and 1.8%; and age 40 to 60 years, 9.4% and 11.1%, respectively. The prevalence of obesity was similar: 42.1% and 39.6%, with similar age and female distribution (41.5% and 41.1%) but different male distribution (42.7% and 37.9%). The overall prevalence of high cholesterol along with age and female distribution was similar in the CEMR and the NHANES: overall prevalence, 12.4% and 12.4%; and female, 14.8% and 13.2%, respectively. The overall prevalence of hypertension was significantly higher in the CEMR (33.5%) than in the NHANES (95% CI: 27.0%-31.0%). Conclusions The distribution of major cardiometabolic diseases in the CEMR is comparable with the national survey results. The CEMR represents the general US population well in terms of office visits and major chronic conditions, whereas the potential subgroup differences in terms of age and gender distribution and prevalence may differ and, therefore, should be carefully taken care of in future studies.

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Care Provision and Prescribing Practices of Physicians Treating Children and Adolescents With ADHD

Abstract: Differences were found by physician type in care of children with ADHD. Additional studies are needed to understand clinical consequences of these differences and the implications for care coordination across provider specialties.

Cited by 28 publications

References 22 publications

Adherence to Recommended Care Guidelines in the Treatment of Preschool-Age Medicaid-Enrolled Children With a Diagnosis of ADHD

Adherence to Recommended Care Guidelines in the Treatment of Preschool-Age Medicaid-Enrolled Children With a Diagnosis of ADHD

Acute stress, behavioural symptoms and mood states among school-age children with attention-deficit/hyperactive disorder during the COVID-19 outbreak

Evaluating the Representativeness of US Centricity Electronic Medical Records With Reports From the Centers for Disease Control and Prevention: Comparative Study on Office Visits and Cardiometabolic Conditions

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