French Blandine, Hall Charlotte, Perez Vallejos Elvira, Sayal Kapil, Daley David
Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
Division of Psychiatry & Applied Psychology School of Medicine, University of Nottingham, Nottingham, United Kingdom.
JMIR Med Educ. 2020 Dec 11;6(2):e19871. doi: 10.2196/19871.
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder affecting up to 5% of children and adults. Undiagnosed and untreated ADHD can result in adverse long-term health, educational, and social impacts for affected individuals. Therefore, it is important to identify this disorder as early as possible. General practitioners (GPs) frequently play a gatekeeper role in access to specialist services in charge of diagnosis and treatment. Studies have shown that their lack of knowledge and understanding about ADHD can create barriers to care.
This pilot randomized controlled trial assesses the efficacy of a web-based psychoeducation program on ADHD tailored for GPs.
A total of 221 participants were randomized to either a sham intervention control or an awareness training intervention and they completed questionnaires on ADHD knowledge, confidence, and attitude at 3 time points (preintervention, postintervention, and 2-week follow-up). Participants in the intervention arm were invited to participate in a survey and follow-up interview between 3 and 6 months after the intervention.
The responses of 109 GPs were included in the analysis. The knowledge (P<.001) and confidence (P<.001) of the GPs increased after the intervention, whereas misconceptions decreased (P=.04); this was maintained at the 2-week follow-up (knowledge, P<.001; confidence, P<.001; misconceptions, P=.03). Interviews and surveys also confirmed a change in practice over time.
These findings demonstrate that a short web-based intervention can increase GPs' understanding, attitude, and practice toward ADHD, potentially improving patients' access to care.
International Standard Randomized Controlled Trial Number ISRCTN45400501; http://www.isrctn.com/ISRCTN45400501.
注意力缺陷多动障碍(ADHD)是一种神经发育障碍,影响着多达5%的儿童和成人。未被诊断和治疗的ADHD会对受影响个体的长期健康、教育和社会产生不利影响。因此,尽早识别这种疾病很重要。全科医生(GPs)在获得负责诊断和治疗的专科服务方面经常扮演把关人的角色。研究表明,他们对ADHD缺乏了解会造成护理障碍。
这项初步随机对照试验评估了一个为全科医生量身定制的基于网络的ADHD心理教育项目的效果。
总共221名参与者被随机分为假干预对照组或认知培训干预组,并在3个时间点(干预前、干预后和2周随访)完成关于ADHD知识、信心和态度的问卷调查。干预组的参与者被邀请在干预后3至6个月参加一项调查和随访访谈。
109名全科医生的回复被纳入分析。干预后,全科医生的知识(P<.001)和信心(P<.001)有所提高,而误解减少(P=.04);在2周随访时保持这种情况(知识,P<.001;信心,P<.001;误解,P=.03)。访谈和调查也证实了随着时间推移实践的变化。
这些发现表明,一个简短的基于网络的干预可以增加全科医生对ADHD的理解、态度和实践,可能改善患者获得护理的机会。
国际标准随机对照试验编号ISRCTN45400501;http://www.isrctn.com/ISRCTN45400501 。