Protocol for the mixed methods, Managing young people (aged 16–25) with Attention deficit hyperactivity disorder in Primary care (MAP) study: mapping current practice and co-producing guidance to improve healthcare in an underserved population

Abstract

IntroductionAttention deficit hyperactivity disorder (ADHD) is the most common neurodevelopmental disorder in children and adolescents, with an average worldwide prevalence of 5%. Up to 40% of young people continue to experience symptoms into adulthood. Young people with ADHD experience poorer outcomes than their peers across multiple domains, with treatment shown to reduce these risks. Primary care practitioners play an important role in healthcare provision for this group in the UK. However, many feel unsure about how best to provide support, reporting prescribing concerns and need for more evidence-based guidance. A lack of national data on primary care provision hinders efforts to improve access to care and optimise outcomes. This mixed-methods study aims to provide evidence that may be used to improve primary care services for young people aged 16–25 years with ADHD.Methods and analysisThere are three interlinked work packages: (a) a mapping study including a survey of stakeholders (healthcare professionals, people with ADHD and commissioners) will map ADHD prescribing practice, shared-care arrangements, available support and practitioner roles by geographic locations across England for different respondent groups; (b) a qualitative study involving semi-structured interviews with stakeholders (10–15 healthcare professionals and 10–15 people with ADHD) will explore experiences of ‘what works’ and ‘what is needed’ in terms of service provision and synthesise findings; (c) workshops will integrate findings from (a) and (b) and work with stakeholders to use this evidence to codevelop key messages and guidance to improve care.Ethics and disseminationThe protocol has been approved by Yorkshire and the Humber—Bradford Leeds Research Ethics Committee. Recruitment commenced in September 2022. Findings will be disseminated via research articles in peer-reviewed journals, conference presentations, public involvement events, patient groups and media releases. A summary of study findings will be shared with participants at the end of the study.Trial registration numberNCT05518435.

Primary care provision for young people with ADHD: a multi-perspective qualitative study

“…Previously, the Managing ADHD in Primary Care (MAP) national survey investigated the provision of supportive elements for ADHD in primary care, reported by people with LE and HPs (19). Potential primary care practice sites were identified via MAP survey respondents and purposively sampled from across England to represent a range of local area characteristics (ethnicity, rural/urban setting, deprivation).…”

“…All participants had to be currently residing or working in England. Further detail of our recruitment strategy can be found in our MAP study protocol (19).…”

“…Data were collected, using semi-structured interviews with topic guides (Supplementary Material). Topic guides were initially developed using questions from the MAP survey and refined following consultation with two research advisory groups (RAGs), who were recruited to support the wider MAP study (19). Members of a young person RAG included young people with ADHD and their supporters, and a practice and policy RAG consisted of practitioners and service commissioners.…”

“…Appropriate support in this period is critical to maintain engagement with treatment, and for future mental health. Therefore, this study aimed to explore the experiences of young people (aged [16][17][18][19][20][21][22][23][24][25] with ADHD when accessing primary healthcare, incorporating perspectives of young people and supporters with lived experience (LE) of ADHD, and primary healthcare professionals (HP). The objectives were to:…”

Provision of digital health interventions for young people with ADHD in primary care: findings from a national survey and scoping review

“…A survey was developed in response to results from a previous study -the Children and Adolescents with ADHD in Transition between Children's and adult Services (CATCh-uS) study -which informed us on the priorities of young people with ADHD with regards to their experiences of primary care. These priorities guided the development of the survey questions for the MAP study, as detailed in the main study protocol (20). Three survey streams were createdhealthcare practitioners (HCP) working in primary care, people with LE, and commissioners of ICBs.…”