Stimulant medications are widely used to control symptoms of Attention Defict Hypercativty Disorder in children and NICE has issued comprehensive guidelines in 2008 about diagnostic criteria based on DSMIV and monitoring of patients on medication
RCPSYCH under QIP through PRESCRIBING OBSERVATORY FOR MENTAL HEALTH -UK (POMH) undertook a national audit – topic 13a “prescribing for ADHD medication” 2013.
Audit tool, sampling options poster and participation were sent to POMH lead contact. Data was collected over a period of one montha and entered on line. data was anaylysed over 6 month period and resuls were published. It measured 6 standards Heart rate, BP, Height, Weight, Cardivascular risk assessment and substance misuse risk before starting treatment, 3 months after and over a year
There were 5479 patients in 48 Trusts under 370 clinical teams. There were 429 Paediatric patients in the sample treated by paediatricians.3737 by CAMHS teams and 1313 adult patients. Children aged 13–8 were the largest group, 83% were male, 80% were caucasian. commonest co morbidities: 25% had sleep disorder, 23% pervasive developmental disoder. Adults had 25% had mood, personality and stress disorder. 30% had no co morbid disoder.
Our Trust compliance was highest in the sample with 100% in all the 6 standards before and 3 months after starting treatment and 88% over the year.
We provide ADHD service in DGH setting and treat ˜ 200 patients per year. We run 4 dedicated clinics a month and have designed specific templates for initial and fup clinics to capture the data and paediatrics is more failiar in plotting growth charts, measuring BP and performing physical examination than CAMHS colleagues which has helped us to do well in this audit. A well focussed team with limited resources can provide high quality care and this has been re inforced by a recent service user survey.
It is unclear from this audit what percentage of services are provided in UK by paediatricians and CAMHS. As the project was initiated by RCPSYCH Paediatricians providing a service were probably not aware hence less data input.
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