Systematic review of national and international guidelines on attention-deficit hyperactivity disorder

Abstract

During the last few years several clinical guidelines on attention-deficit hyperactivity disorder (ADHD) have been published by national and international medical societies. To systematically review and compare recommendations of selected ADHD guidelines, we performed a systematic search in online guideline databases and PubMed in order to retrieve guideline texts. Guidelines meeting inclusion criteria were reviewed and recommendations on assessment and treatment extracted. The AGREE instrument was used to assess methodological quality. Of the 26 guidelines identified, 13 were selected for further analysis: 11 guidelines deal with ADHD in childhood and adolescence and 5 guidelines cover transitional patients and/or ADHD in adults. The methodological quality of ADHD guidelines is moderate to good. They reflect similarities and differences of healthcare systems. Diagnosis throughout the lifespan is based on a detailed clinical history. There is greater agreement on evidence-based pharmacological treatment than on psychosocial interventions, reflecting the strength of evidence.

A Systematic Review of Combination Therapy with Stimulants and Atomoxetine for Attention-Deficit/Hyperactivity Disorder, Including Patient Characteristics, Treatment Strategies, Effectiveness, and Tolerability

“…Some patients may try several ADHD medications before they experience adequate and tolerable symptom relief (Pliszka et al 2006;Prasad and Steer 2008), as was the case for some patients who were given stimulant and atomoxetine combination therapy (Brown 2004). This is because current guidelines recommend full monotherapy trials of stimulants and atomoxetine for ADHD treatment (Pliszka et al 2006;National Institute for Health and Clinical Excellence 2008;Seixas et al 2012). In addition, identifying patient characteristics or factors that may help physicians tailor treatment regimens has, to date, been mostly unsuccessful (Quintana et al 2007).…”

“…Psychopharmacological treatment for ADHD includes stimulant or, if warranted, nonstimulant (e.g., atomoxetine, bupropion, clonidine, guanfacine) medications (Pliszka et al 2006; National Institute for Health and Clinical Excellence 2008; Seixas et al 2012). In addition to psychopharmacological treatment, nonpsychopharmacological interventions (e.g., behavior modification) are also required in most cases because of the complexity of ADHD symptoms and their diverse presentation (Hodgson et al 2012).…”

A Study of Comparative Clinical and Socio-Economic Characteristics of School-Age Children Screened for ADHD: Implications for Development of ADHD Clinical Care Pathway

“…A number of national and regional guidelines have been produced to help streamline and standardize the assessment and management of ADHD in children and adolescents [3,[19][20][21][22][23]. There is still a wide range of variation in adherence of clinical practice to available guidelines among various healthcare paediatric professionals involved in managing children with ADHD and across various locations [24][25][26].…”

Correlation between Conners' Parent Rating Scale and autonomic functions in ADHD before and after methylphenidate

“…ADHD is a behavioral and neurocognitive condition characterized by developmentally inappropriate and impairing levels of gross motor over activity, inattention, and impulsivity 2 . ADHD is treated with psycho-education, Cognitive behavioral therapy techniques, and pharmacotherapy 3,4 . The Methylphenidate is one of the most commonly used medications for ADHD treatment 5 .…”