Mitchell Philip B, Levy Florence, Hadzi-Pavlovic Dusan, Concannon Patrick E, Hutchins Paul, Mulcahy Desmond L, Clarke Simon D, Salmelainen Pia A, Warner Alexandra, Hughes Clifford F
School of Psychiatry, University of New South Wales, Prince of Wales Hospital, Hospital Road, Randwick, New South Wales, Australia.
J Paediatr Child Health. 2012 Jun;48(6):483-9. doi: 10.1111/j.1440-1754.2011.02242.x. Epub 2011 Nov 23.
To investigate whether recent Australian practice conforms to the draft 2009 National Health and Medical Research Council (NHMRC) guidelines on the management of attention deficit hyperactivity disorder.
Data from the 2007 Special Review on Attention Deficit Hyperactivity Disorder in Children and Adolescents in New South Wales (NSW) were examined.
Two hundred seven approved stimulant prescribers in NSW responded to a detailed survey on treatment practice (including 121 paediatricians and 67 psychiatrists). Overall, the practice identified in this survey of NSW approved stimulant prescribers was consistent with that recommended in the draft NHMRC guidelines. Paediatricians were more likely to inform families of developmental therapies. Most prescribers (67%) considered stimulants to be the first line of treatment for at least half of their patients. Psychiatrists were more likely to use stimulants as first-line treatments, while those recently qualified were less likely to prescribe. Half of the prescribers were willing to consider prescribing for children 4 years of age and younger. Paediatricians were more likely to consider prescribing to this age group, while those recently qualified were less likely. There were no significant differences in prescribing practice between child and adult psychiatrists. Most prescribers (67-97%) routinely monitored patients on stimulants for weight, height, blood pressure and academic progress. Psychiatrists were less likely to review these parameters than paediatricians, with this difference being largely due to adult psychiatrists.
There are significant differences in prescribing practice between paediatricians and psychiatrists. These variations may reflect differing training programs and patient populations, and merit close consideration in any review arising from the publication of the recent NHMRC guideline.
调查澳大利亚近期的医疗实践是否符合2009年国家卫生与医学研究委员会（NHMRC）关于注意缺陷多动障碍管理的指南草案。
对新南威尔士州（NSW）2007年儿童和青少年注意缺陷多动障碍特别审查的数据进行了检查。
新南威尔士州207名获批的兴奋剂处方医生对一项关于治疗实践的详细调查做出了回应（包括121名儿科医生和67名精神科医生）。总体而言，本次对新南威尔士州获批兴奋剂处方医生的调查中所发现的实践与NHMRC指南草案中推荐的一致。儿科医生更有可能告知家庭发育疗法。大多数处方医生（67%）认为兴奋剂是至少一半患者的一线治疗方法。精神科医生更有可能将兴奋剂用作一线治疗，而那些刚获得资格的医生开药的可能性较小。一半的处方医生愿意考虑为4岁及以下儿童开药。儿科医生更有可能考虑为这个年龄组开药，而那些刚获得资格的医生可能性较小。儿童精神科医生和成人精神科医生在开药实践上没有显著差异。大多数处方医生（67%-97%）常规监测服用兴奋剂患者的体重、身高、血压和学业进展。精神科医生比儿科医生审查这些参数的可能性小，这种差异主要归因于成人精神科医生。
儿科医生和精神科医生在开药实践上存在显著差异。这些差异可能反映了不同的培训项目和患者群体，并且在NHMRC近期指南发布引发的任何审查中都值得密切关注。
