Evaluation of a new model for assessment and treatment of uncomplicated ADHD–effect, patient satisfaction and costs

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Evaluation of a new model for assessment and treatment of uncomplicated ADHD–effect, patient satisfaction and costs. / Wernersson, Rebecca; Johansson, Jan; Andersson, Markus; Jarbin, Håkan.

In: Nordic Journal of Psychiatry, Vol. 74, No. 2, 2020, p. 96-104.

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T1 - Evaluation of a new model for assessment and treatment of uncomplicated ADHD–effect, patient satisfaction and costs

AU - Wernersson, Rebecca

AU - Johansson, Jan

AU - Andersson, Markus

AU - Jarbin, Håkan

PY - 2020

Y1 - 2020

N2 - Aim: Attention-deficit/hyperactivity disorder (ADHD) is the most common diagnosis within child- and adolescent psychiatry. Waiting lists and delayed care are major issues. The aim was to evaluate if standardized care (SC) for assessment and treatment of uncomplicated ADHD would reduce resource utilization and increase satisfaction with preserved improvement within the first year of treatment. Method: Patients 6–12 years with positive screen for uncomplicated ADHD at the brief child and family phone interview (BCFPI), a routine clinical procedure, were triaged to SC. The control group consisted of patients diagnosed with ADHD in 2014 and treated as usual. BCFPI factors at baseline and follow-up after one year and resource utilization were compared. Results: Patients improved in ADHD symptoms (Cohen’s d = 0.78, p < 0.001), child function (Cohen’s d = 0.80, p < 0.001) and in family situation (Cohen’s d = 0.61, p < 0.001) without group differences. Parents of SC patients participated more often in psychoeducational groups (75.5 vs. 49.5%, p < 0.001). SC had shorter time to ADHD diagnosis (8.4 vs. 15.6 weeks, p = 0.01) and to medication (24.6 vs. 32.1 weeks, p = 0.003). SC families were more satisfied with the waiting time (p = 0.01), otherwise there were no differences in satisfaction between the groups. Families of SC patients had fewer visits (4.7 vs. 10.8, p < 0.001) but used the same number of phone calls (6.3 vs. 6.2, p = 0.71). Costs were 55% lower. Conclusions: A SC for ADHD can markedly reduce costs with preserved quality. As resources are limited, child psychiatry would benefit from standardization.

AB - Aim: Attention-deficit/hyperactivity disorder (ADHD) is the most common diagnosis within child- and adolescent psychiatry. Waiting lists and delayed care are major issues. The aim was to evaluate if standardized care (SC) for assessment and treatment of uncomplicated ADHD would reduce resource utilization and increase satisfaction with preserved improvement within the first year of treatment. Method: Patients 6–12 years with positive screen for uncomplicated ADHD at the brief child and family phone interview (BCFPI), a routine clinical procedure, were triaged to SC. The control group consisted of patients diagnosed with ADHD in 2014 and treated as usual. BCFPI factors at baseline and follow-up after one year and resource utilization were compared. Results: Patients improved in ADHD symptoms (Cohen’s d = 0.78, p < 0.001), child function (Cohen’s d = 0.80, p < 0.001) and in family situation (Cohen’s d = 0.61, p < 0.001) without group differences. Parents of SC patients participated more often in psychoeducational groups (75.5 vs. 49.5%, p < 0.001). SC had shorter time to ADHD diagnosis (8.4 vs. 15.6 weeks, p = 0.01) and to medication (24.6 vs. 32.1 weeks, p = 0.003). SC families were more satisfied with the waiting time (p = 0.01), otherwise there were no differences in satisfaction between the groups. Families of SC patients had fewer visits (4.7 vs. 10.8, p < 0.001) but used the same number of phone calls (6.3 vs. 6.2, p = 0.71). Costs were 55% lower. Conclusions: A SC for ADHD can markedly reduce costs with preserved quality. As resources are limited, child psychiatry would benefit from standardization.

KW - ADHD

KW - Child

KW - outcome

KW - resource utilization

KW - standardized care

U2 - 10.1080/08039488.2019.1674377

DO - 10.1080/08039488.2019.1674377

M3 - Article

C2 - 31596156

AN - SCOPUS:85074482483

VL - 74

SP - 96

EP - 104

JO - Nordisk Psykiatrisk Tidsskrift

JF - Nordisk Psykiatrisk Tidsskrift

SN - 1502-4725

IS - 2

ER -