Olufs Erin L, Valleley Rachel J, Hembree Kristen C, Evans Joseph H
Department of Psychology, Institute on Development and Disability, Oregon Health and Science University.
Department of Psychology, Munroe-Meyer Institute, University of Nebraska Medical Center.
Fam Syst Health. 2016 Sep;34(3):221-8. doi: 10.1037/fsh0000210.
As behavioral health providers integrate into primary health care clinics, it is important to examine methods used to increase primary care providers' (PCPs) knowledge of behavioral health providers' areas of expertise and service provision. Attention-deficit/hyperactivity disorder (ADHD) has been identified as one of the most common behavioral health disorders PCPs diagnose and treat in children.
This study examined whether 2 brief educational "curbside consults," during which a psychologist provided information regarding the assessment and treatment of ADHD, had an impact on PCPs' referral practices. Information was collected via medical records review for the same 6-month period prior to and following provider education.
The results indicated that there was an increase in ADHD referrals to the behavioral health clinic (BHC) following educational consultation. In addition, there was some evidence to suggest that following PCP education, fewer children were diagnosed by the PCP with ADHD and fewer children were previously prescribed a psychotropic medication upon referral to the BHC. Treatment (e.g., behavioral therapy, pharmacotherapy, combined approach) also differed between families previously diagnosed and prescribed psychotropic medication.
The current study provides some preliminary evidence that brief educational consultation with PCPs may increase both referrals for ADHD concerns and may influence the way PCPs diagnose and address behavioral health concerns. Implications of these findings and suggestions for future research are discussed. (PsycINFO Database Record
随着行为健康服务提供者融入初级医疗保健诊所，审视用于增加初级保健提供者（PCP）对行为健康服务提供者专业领域和服务提供知识的方法非常重要。注意力缺陷多动障碍（ADHD）已被确定为PCP在儿童中诊断和治疗的最常见行为健康障碍之一。
本研究考察了两次简短的教育性“路边咨询”（期间一位心理学家提供了有关ADHD评估和治疗的信息）是否会对PCP的转诊行为产生影响。通过回顾提供者教育前后相同6个月期间的医疗记录来收集信息。
结果表明，教育咨询后转介到行为健康诊所（BHC）的ADHD病例有所增加。此外，有一些证据表明，在PCP接受教育后，被PCP诊断为ADHD的儿童减少，转诊到BHC时之前被开具精神药物的儿童也减少。之前被诊断并开具精神药物的家庭在治疗（如行为疗法、药物疗法、联合疗法）方面也存在差异。
当前研究提供了一些初步证据，即与PCP进行简短的教育咨询可能会增加对ADHD问题的转诊，并可能影响PCP诊断和处理行为健康问题的方式。讨论了这些发现的意义以及对未来研究的建议。（PsycINFO数据库记录 ）
