Implementation of an Adult ADHD Toolkit in Primary Care: A Prospective Cohort Survey.

Abstract

OBJECTIVE\nAttention-deficit/hyperactivity disorder (ADHD) in adulthood presents unique challenges for primary care providers, and many lack confidence addressing it. To support them, a workgroup of volunteer primary care and mental health providers created an Adult ADHD Toolkit containing information about the disorder and treatment advice. The objective of this study was to establish the impact of implementing the toolkit in primary care.\n\n\nMETHODS\nProviders completed a survey immediately before and 5 months after the toolkit was implemented. Participation was voluntary and anonymous. Also, prescriptions for stimulant and nonstimulant adult ADHD medications were tracked 6 months before and 6 months after the toolkit was introduced.\n\n\nRESULTS\nThe response rate was 77.4% (n=24) at baseline and 64.5% (n=20) at follow-up. At follow-up compared to baseline, participants reported significantly higher comfort for assessment of adult ADHD (P=.039). Participants also reported higher comfort for nonmedication management (P=.10). There was no difference for comfort with medication management or prescribing practices pre versus post toolkit rollout, although participants were more comfortable with and prescribed a greater number of stimulants than nonstimulants.\n\n\nCONCLUSIONS\nGiven the complexities of addressing adult ADHD, the results of this study are encouraging. Our findings highlight ways primary care providers can be supported, as well as areas that require greater attention. Still, more research is needed with a larger sample size to further explore and validate the efficacy of the toolkit.