Disclosure of interests: None of the authors have received any remuneration from pharmaceutical companies nor have been members of industry advisory committees in the last 36 months. No remuneration was received by any authors in the preparation of this article from either industry or government sources.
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Practitioner characteristics and the treatment of children and adolescents with attention deficit hyperactivity disorder
Article first published online: 23 NOV 2011
DOI: 10.1111/j.1440-1754.2011.02242.x
© 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians)
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How to Cite
Mitchell, P. B., Levy, F., Hadzi-Pavlovic, D., Concannon, P. E., Hutchins, P., Mulcahy, D. L., Clarke, S. D., Salmelainen, P. A., Warner, A. and Hughes, C. F. (2012), Practitioner characteristics and the treatment of children and adolescents with attention deficit hyperactivity disorder. Journal of Paediatrics and Child Health, 48: 483–489. doi: 10.1111/j.1440-1754.2011.02242.x
Publication History
- Issue published online: 13 JUN 2012
- Article first published online: 23 NOV 2011
- Accepted for publication 20 August 2011.
- Abstract
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Keywords:
- attention deficit hyperactivity disorder;
- paediatrician;
- prescribing;
- psychiatrist;
- stimulant
Aim: To investigate whether recent Australian practice conforms to the draft 2009 National Health and Medical Research Council (NHMRC) guidelines on the management of attention deficit hyperactivity disorder.
Methods: Data from the 2007 Special Review on Attention Deficit Hyperactivity Disorder in Children and Adolescents in New South Wales (NSW) were examined.
Results: Two hundred seven approved stimulant prescribers in NSW responded to a detailed survey on treatment practice (including 121 paediatricians and 67 psychiatrists). Overall, the practice identified in this survey of NSW approved stimulant prescribers was consistent with that recommended in the draft NHMRC guidelines. Paediatricians were more likely to inform families of developmental therapies. Most prescribers (67%) considered stimulants to be the first line of treatment for at least half of their patients. Psychiatrists were more likely to use stimulants as first-line treatments, while those recently qualified were less likely to prescribe. Half of the prescribers were willing to consider prescribing for children 4 years of age and younger. Paediatricians were more likely to consider prescribing to this age group, while those recently qualified were less likely. There were no significant differences in prescribing practice between child and adult psychiatrists. Most prescribers (67–97%) routinely monitored patients on stimulants for weight, height, blood pressure and academic progress. Psychiatrists were less likely to review these parameters than paediatricians, with this difference being largely due to adult psychiatrists.
Conclusions: There are significant differences in prescribing practice between paediatricians and psychiatrists. These variations may reflect differing training programs and patient populations, and merit close consideration in any review arising from the publication of the recent NHMRC guideline.