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September 14, 2021
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AAFP’s Adult ADHD Toolkit ‘measurably’ raises awareness of the disorder

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The American Academy of Family Physicians’ web-based Adult ADHD Toolkit “measurably increased” awareness of the disorder among health care providers, researchers wrote.

Perspective from Maggie Sibley, PhD

Adults affected by ADHD usually see their primary care practitioner before any other health care professional, according to Natalia Y. Loskutova, MD, PhD, a project director at the University of Kansas Medical Center and one of the toolkit’s creators, and colleagues.

The quote is It is important for primary care physicians to have accessible, evidence-based information on ADHD.  The source of the quote is: Maggie Sibley PhD.

However, “primary care practitioners receive little training for diagnosing and treating adult ADHD and know little about the comparative effectiveness and cost-effectiveness of the diagnostic and treatment options for this disorder,” they wrote in the Journal of the American Board of Family Medicine.

The development of the toolkit was overseen by seven health care professionals and an adult with the disorder, according to the researchers. It contains information about assessing, diagnosing, treating and managing ADHD in specific groups, including teens, young adults, older adults, individuals with substance use disorder and those with a co-existing mental health condition.

In the new study, the researchers used a single-arm repeated measures intervention approach to gauge the tool’s clinical value. They administered a survey to 97 primary and behavioral health care providers within six different practices to obtain the providers’ demographics, knowledge, confidence and needs around various aspects of adult ADHD care. The providers were trained on the toolkit and used it for 17 weeks while the researchers kept track of the providers’ knowledge, confidence and perceived value of the toolkit, as well as when, how and why they used it.

Loskutova and colleagues reported that the AAFP ADHD Adult Toolkit improved health care providers’ knowledge by the study’s midpoint compared with baseline in domains related to treatment effects, adverse events and outcomes (3.6 vs 3; P = .004); existing ADHD resources (3.3 vs. 2.9; P = .03); and ADHD management in patients with comorbid conditions (3.2 vs. 2.7; P = .01).

By the time the study ended, utilization of the toolkit was linked to increased confidence in mental health and life history interview techniques (3.5 vs. 3; P = .03); treatment options for ADHD with co-existing mental health disorders (3.2 vs. 2.3; P .001) and treatment options for ADHD with co-existing substance use disorders (3 vs. 2.3; P = .003). In addition, 87% of the health care providers reported the toolkit addressed most of their needs related to diagnosis, treatment and management of adult ADHD.

Some of the limitations to the study were its short implementation window and that 63% of the providers said they did not see any patients with ADHD during the study period, according to the researchers. Still, they concluded that “the web-based toolkit is an effective strategy to deliver much-needed information to practicing clinicians and their patients.”

“The PCPs and their patients will also benefit from additional relevant education and an array of resources easily available at the point of care,” Loskutova and colleagues wrote.