Pliszka S R, Greenhill L L, Crismon M L, Sedillo A, Carlson C, Conners C K, McCracken J T, Swanson J M, Hughes C W, Llana M E, Lopez M, Toprac M G
Department of Psychiatry, University of Texas Health Science Center, San Antonio, USA.
J Am Acad Child Adolesc Psychiatry. 2000 Jul;39(7):908-19. doi: 10.1097/00004583-200007000-00021.
Expert consensus methodology was used to develop evidence-based, consensually agreed-upon medication treatment algorithms for attention-deficit/hyperactivity disorder (ADHD) in the public mental health sector. Although treatment algorithms for adult mental disorders have been developed, this represents one of the first attempts to develop similar algorithms for childhood mental disorders. Although these algorithms were developed initially for the public sector, the goals of this approach are to increase the uniformity of treatment and improve the clinical outcomes of children and adolescents with ADHD in a variety of treatment settings.
A consensus conference of academic clinicians and researchers, practicing clinicians, administrators, consumers, and families was convened to develop evidence-based consensus algorithms for the pharmacotherapy of childhood ADHD. After a series of presentations of current research evidence and panel discussion, the consensus panel met and drafted the algorithms along with guidelines for implementation.
The panel developed consensually agreed-upon algorithms for ADHD with and without specific comorbid disorders. The algorithms consist of systematic strategies for psychopharmacological interventions and tactics to ensure successful implementation of the strategies. While the algorithms focused on the medication management of ADHD, the conference emphasized that psychosocial treatments are often a critical component of the overall management of ADHD.
Medication algorithms for ADHD can be developed with consensus. A companion article will discuss the implementation of these algorithms.
采用专家共识方法,为公共心理健康部门制定基于证据、经各方商定的注意力缺陷多动障碍(ADHD)药物治疗算法。尽管已经制定了成人精神障碍的治疗算法,但这是首次尝试为儿童精神障碍开发类似算法。尽管这些算法最初是为公共部门开发的,但这种方法的目标是提高治疗的一致性,并改善在各种治疗环境中患有ADHD的儿童和青少年的临床结局。
召开了一次由学术临床医生和研究人员、执业临床医生、管理人员、消费者及家庭参加的共识会议,以制定基于证据的儿童ADHD药物治疗共识算法。在一系列当前研究证据的展示和小组讨论之后,共识小组开会并起草了算法以及实施指南。
该小组制定了针对有无特定共病障碍的ADHD的各方商定的算法。这些算法包括心理药物干预的系统策略以及确保策略成功实施的策略。虽然算法侧重于ADHD的药物管理,但会议强调心理社会治疗通常是ADHD整体管理的关键组成部分。
可以通过共识制定ADHD的药物算法。一篇配套文章将讨论这些算法的实施。