Martínez-Bermejo A, Moreno-Pardillo D M, Soler-López B
Servicio de Neurología Pediátrica. Hospital Universitario La Paz, Madrid, España.
Rev Neurol. 2008;47(9):451-6.
Attention deficit hyperactivity disorder (ADHD) is currently of great interest to the public and the diagnostic process, evaluation of the follow-up and therapeutic strategies in these patients are the subject of a fierce debate. In this study we assess compliance with the ADHD diagnostic and therapeutic guidelines in Spain, in relation to the American Academy of Pediatrics (AAP) guidelines, and it is measured using the Achievable Benchmarks of Care (ABC) technique.
The study involved 215 specialists, 138 child and youth psychiatrists, and 77 neuropaediatricians. Questions were selected to elicit responses on compliance with the AAP diagnostic (1 to 5) and therapeutic (1 to 5) guidelines. The ABC technique, developed at the University of Alabama, Birmingham, USA, was applied for the analysis.
The degree of compliance with the diagnostic guidelines was: guideline 2, 63.1% (ABC 100%), guidelines 3 and 4, 65.8% (ABC 100%) and guideline 5, 87% (ABC 100%); and in the treatment guidelines: guideline 2, 87.1% (ABC 100%) and guideline 3, 71.2% (ABC 100%).
Compliance with the AAP guidelines for treating patients with ADHD is higher than observance of the diagnostic guidelines. In 10% of the best centres (ABC) compliance reaches 100% of all the guidelines, a high degree of adherence to the US guidelines, although compliance with them is not mandatory in our clinical area.
注意缺陷多动障碍(ADHD)目前备受公众关注,这些患者的诊断过程、随访评估及治疗策略是激烈辩论的主题。在本研究中,我们评估了西班牙对ADHD诊断和治疗指南的遵循情况,与美国儿科学会(AAP)指南相关,并使用可实现的护理基准(ABC)技术进行衡量。
该研究涉及215名专家,其中138名儿童和青少年精神科医生以及77名神经儿科医生。所选问题旨在引出关于遵循AAP诊断(1至5)和治疗(1至5)指南的回答。采用美国阿拉巴马大学伯明翰分校开发的ABC技术进行分析。
诊断指南的遵循程度为:指南2,63.1%(ABC 100%),指南3和4,65.8%(ABC 100%),指南5,87%(ABC 100%);治疗指南方面:指南2,87.1%(ABC 100%),指南3,71.2%(ABC 100%)。
对ADHD患者遵循AAP治疗指南的情况高于诊断指南。在10%的最佳中心(ABC),所有指南的遵循率达到100%,对美国指南的遵循程度较高,尽管在我们的临床领域遵循这些指南并非强制性的。