Attention Deficit/Hyperactivity Disorder
Conditions
Brief summary
The purpose of this study is to compare the effectiveness of two care models on ADHD outcomes: one, a model of basic care management and structured communication with specialists, consistent with conventional descriptions of a patient-centered Medical Home; and another, which combines the Medical Home with theory-based care management strategies to address common reasons for ADHD treatment failure.
Interventions
BEHAVIORALCollaborative Care Plus
Traditional collaborative care + systematic addressing of ADHD comorbidities, parental mental health issues, and adherence to treatment plans
BEHAVIORALTraditional Collaborative Care
Traditional collaborative care, in which care managers serve as intermediaries between primary care physicians and specialists
Sponsors
Codman Square Health Center
Dorchester House Health Center
Boston Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
TRIPLE (Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
6 Years to 12 Years
Healthy volunteers
Yes
Inclusion criteria
* Child is being evaluated for a potential diagnosis of ADHD by a primary care pediatrician at one of our sites. * Child is 6 to 12 years of age * Family plans to remain in the Boston area for the duration of the follow-up period * Mother is comfortable in English or Spanish
Exclusion criteria
* Child already has a confirmed diagnosis of ADHD * Child already receives ongoing specialty care in one or more of the following clinics: pediatric psychiatry, developmental behavioral pediatrics
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| ADHD Symptoms | 6 mo | Swanson, Nolan and Pelham scale (SNAP-IV) |
| Patient Medication Adherence | 6 mo | Timely prescribed refills of ADHD medications - assessed through the EHR - will provide an accurate picture of medication adherence from the perspective of prescription writing. In addition, we will administer the validated Medication Adherence Scale, which has good reliability among parents of urban children with asthma |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| ODD Symptoms | 6 mo | SNAP-IV |
| Social Skills | 6 mo | Social Skills Rating System |
| Time to Symptom Improvement | 12 mo | Based on follow-up ADHD symptom scales administered at regular intervals by our care managers, we will quantify the time between initial diagnosis and definitive improvement - conventionally defined by a 25% symptom reduction from baseline |
Countries
United States
Outcome results
None listed