Attitudes and reported practice of paediatricians and child psychiatrists regarding the assessment and treatment of ADHD in Ireland

Abstract

ObjectivesThis mixed-method national survey has obtained original data on attention deficit hyperactivity disorder (ADHD) attitudes, assessment and treatment regimes reported by paediatricians and child psychiatrists; and has compared their clinics. It has examined the extent of involvement of Irish paediatricians in the management of ADHD.MethodsA questionnaire was designed, based on a review of literature and ADHD guidelines, and piloted by expert clinicians. Universal recruitment was conducted among Child and Adolescent Mental Health Services (CAMHS) consultants (n=71) and community/general paediatric consultants (n=72). Quantitative and qualitative data was collected and analysed.ResultsThere was an overall response rate of 43%. A dedicated ADHD clinic is offered in 79% of CAMHS services, but only in one paediatric service. Participants reported that the assessment of ADHD involves multidisciplinary work and this was only established in CAMHS clinics. Medication is initiated by 82% of child psychiatrists and only 22% of paediatricians.ConclusionsThis first national study of ADHD attitudes and practices presents comprehensive data regarding the management of children with ADHD in CAMHS and paediatric settings in Ireland. Paediatricians reported a minor role in managing ADHD. Study limitations are related to subjective reporting rather than case note audit, and a moderate response rate for the paediatricians’ participants.

A mixed methods study of clinician reported challenges in the assessment of ADHD and treatment decisions for children with ADHD in Brazil

“…The survey instrument was first designed in English to initially collect data from an Irish clinical population (Honorio Neto et al, 2017). The translation of the survey followed a validity process to ensure a linguistically and culturally equivalent translation of the original instrument in English to Portuguese (Cha et al, 2007; Tran et al, 2017).…”

Trends in attention-deficit and hyperactivity disorder (ADHD) medications among children and young adults in Ireland: a repeated cross-sectional study from 2005 to 2015

“…In Ireland, the majority of children and adolescents with suspected ADHD are referred to Child and Adolescent Mental Health Services (CAMHS) for assessment, while some children are assessed by paediatricians. 34 During the study period, there was an increase in the number of CAMHS available in Ireland from 49 in 2008 to 63 in 2015, which may have contributed to an increase in the prescribing of ADHD medications during the study due to increased diagnosis of the condition. 35 The increase in prescribing of ADHD medications reported in many countries has led to some concern that this may represent inappropriate prescribing of these medications.…”