Harstad Elizabeth, Blum Nathan, Gahman Amy, Shults Justine, Chan Eugenia, Barbaresi William
*Division of Developmental Medicine, Boston Children's Hospital, Boston, MA; †Behavioral Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA; ‡Division of Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA.
J Dev Behav Pediatr. 2016 Sep;37(7):541-7. doi: 10.1097/DBP.0000000000000329.
To describe practice patterns for developmental-behavioral pediatricians (DBPs) practicing within Developmental-Behavioral Pediatrics Research Network (DBPNet) academic medical centers providing follow-up for children with attention-deficit/hyperactivity disorder (ADHD) and determine how well they adhere to American Academy of Pediatrics ADHD Clinical Practice Guidelines.
Seventy-eight DBPs at 12 academic medical centers participating in the DBPNet were asked to complete follow-up encounter surveys for patients with ADHD or autism spectrum disorder seen from 12/2011 through 6/2012. Data regarding patient characteristics, comorbid conditions, and medication management were obtained at the time of each visit.
Fifty-seven DBPs completed 301 ADHD follow-up encounter surveys; 75.3% of patients were male with mean age 9.57 years (SD = 3.3). Race/ethnicity was primarily white/non-Hispanic with similar numbers on private insurance (41.5%) versus Medicaid (45.5%). DBPs identified comorbid learning disorders in 27.6% of children ≥6 years. Only 58.3% of children <6 years received counseling/behavioral therapy or had it recommended during the visit. DBPs primarily (90.6%) prescribed medications FDA-approved for ADHD treatment and growth was monitored for >98% of visits during which stimulants were prescribed. Parent- and teacher-completed rating scales were reviewed/completed during 43.9% and 37.8% of visits, respectively. There were no child or physician factors consistently associated with variation in practice patterns.
Developmental-behavioral pediatricians practicing within DBPNet medical centers adhere to the recommended medication prescribing practices for ADHD, including use of FDA-approved medications and monitoring growth. However, DBPs within DBPNet do not consistently review ADHD rating scales or recommend behavioral counseling for children <6 years of age as recommended.
描述在发育行为儿科学研究网络（DBPNet）学术医疗中心工作的发育行为儿科医生（DBP）对注意力缺陷多动障碍（ADHD）儿童进行随访的实践模式，并确定他们对美国儿科学会ADHD临床实践指南的遵循程度。
邀请参与DBPNet的12家学术医疗中心的78名DBP完成对2011年12月至2012年6月期间诊治的ADHD或自闭症谱系障碍患者的随访会诊调查。每次就诊时收集患者特征、共病情况和药物管理等数据。
57名DBP完成了301份ADHD随访会诊调查；75.3%的患者为男性，平均年龄9.57岁（标准差=3.3）。种族/族裔主要为白人/非西班牙裔，拥有私人保险（41.5%）和医疗补助（45.5%）的人数相近。DBP在27.6%的6岁及以上儿童中发现了共病学习障碍。6岁以下儿童中只有58.3%在就诊期间接受了咨询/行为治疗或被建议接受此类治疗。DBP主要（90.6%）开具美国食品药品监督管理局（FDA）批准用于ADHD治疗的药物，在98%以上开具兴奋剂的就诊中监测了生长情况。分别在43.9%和
