UnknownNot Applicable

Pilot Study of Shared Care of ADHD in a Pediatric Clinic:Colocation of a Psychologist as an ADHD Care Manager

United States140 participantsStarted 2006-08

Plain-language summary

Due to the shortage of child psychiatrists and the high prevalence of child mental health disorder, pediatricians and other pediatric primary care providers often assume responsibility for the management of various psychiatric disorders, including ADHD, Attention Deficit Hyperactivity Disorder. However, pediatricians have not been well-trained during residency to deal with the complexities of ADHD management. In addition, the system of care under which pediatricians practice do not afford the time availability that is required to properly manage a child with ADHD. On the other hand, if a pediatrician wishes to refer a patient to a child mental health specialist, many obstacles, including but not limited to stigma, insurance issues, and long waiting lists, often interfere with the patient actually receiving services for his/her ADHD. This research project seeks to examine an innovative model of care in which a child psychologist is located on the premises of a pediatric office and is available to share the care of patients with the pediatrician in order to address ADHD. We hypothesize that parents as well as pediatricians will be more satisfied with this model of care and that patients will ultimately have better outcomes. The beginning of our pilot has shown under-identification to be a barrier to care as well, and thus we propose to implement a quality improvement initiative to screen children for psychosocial issues as well. As we have had trouble with recruitment and unfortunately have had more children randomized to TAU than shared care, we propose in December 2007 a phase 2 of our study where all subjects, instead of randomization, are entered into shared care.

Who can participate

Age range6 Years – 17 Years

SexALL

See this in plain English?

AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.

Inclusion Criteria (Patient subjects): * Age 6-17 * Suspected diagnosis of ADHD, inattentive type, hyperactive type, combined type, NOS * Living with Guardian for at least 6 months * English-speaking child * English-speaking guardian * Telephone Access to Guardian * Inclusion for Randomization or Phase 2 shared care: * Diagnosis of ADHD Exclusion Criteria: * Mental Retardation * Co-morbid psychotic disorder * Suicidal * Homicidal * Dangerous behavior * Foster care * Impairing co-morbid psychiatric disorder that would make ADHD treatment in a pediatric clinic unsafe or inappropriate (in the judgment of the PI based on the case review of the findings of the clinical psychologist.) * Allergic or contraindication to stimulant medications Inclusion Criteria (Provider subjects): * Provider at Cornell Campus Helmsley Tower 5/ Long Island City Campus Exclusion Criteria: * None Inclusion for screening: * Age 6-17 * Child is to be seen by pediatric provider at HT5 * Parent or guardian reads English or Spanish Exclusion Criteria: * Parent/Guardian has received screen within the year * Patient is too sick for parent to spend time on form

What they're measuring

A higher proportion of patients treated by the pediatric providers and psychologists than those in usual care receive doses of medication that are consistent with AAP (American Academy of Pediatrics) recommendations

Timeframe: six months

Trial details

NCT IDNCT00644566

SponsorWeill Medical College of Cornell University

Sponsor typeOTHER

Study typeINTERVENTIONAL

Primary completion2008-06

Contact for this trial

Rachel A Zuckerbrot, MD

212-543-2628 zuckerbr@childpsych.columbia.edu