Managing Young People With ADHD in Primary Care Study — MAP  

ADHD Clinical Trial

Official title: Managing Young People With Attention Deficit Hyperactivity Disorder in Primary Care (MAP) Study: Mapping Current Practice and Co-producing Guidance to Improve Healthcare in an Underserved Population

Status Completed

Clinical Trial Summary

Background:

Attention deficit hyperactivity disorder (ADHD) is the most common childhood neurodevelopmental disorder. It affects around 5% of children and adolescents, and up to 40% continue to experience symptoms into adulthood. Primary care practitioners (e.g., general practitioners (GPs), nurses, link workers, clinical pharmacists) play an important role in the healthcare of young people (YP) with ADHD, particularly due to long waiting times in adult mental health services, and patchy provision of specialist services. However, many practitioners feel unsure about how to support YP at this vulnerable stage in their lives. Practitioners report concerns about prescribing ADHD medication and a desire for more guidance. Currently, little is known about how YP with ADHD are supported in primary care, the strengths and weakness of existing care pathways, and how care can be improved.

Aims:

To provide an evidence-base by mapping current services, and co-produce guidance to improve and better co-ordinate primary care for YP aged 16-25 with ADHD.

Methods:

Three interlinked studies. A mapping study including a national survey of stakeholders to map patient pathways, prescribing practice, shared-care arrangements, and practitioner roles. A qualitative study including semi-structured interviews with YP and practitioners, to gain insight into experiences of 'what works' and 'what is needed'. Workshops to co-develop a map of patient pathways, key messages, and clinical guidance.

Patient Involvement:

This research has been developed in response to identified gaps in services, and requests from people with ADHD. The team includes young people with ADHD whose input will help ensure the research is sensitive and relevant, and an academic GP to ensure identified solutions are deliverable within primary care settings.

Impact:

The expected impact of this research is improvement of the quality and experience of care for YP with ADHD. Also, to improve experiences of primary care providers facing difficulties managing ADHD.

Clinical Trial Description

This research aims to map current services and co-create evidence-based guidance to improve and better co-ordinate primary care for young people aged 16-25 years with ADHD.

OBJECTIVES

The objectives of this research are to:

1. Develop a national map and overview of current primary care pathways and prescribing practice in the management of young people with ADHD

2. Explore:

1. Primary care providers and related organisations' needs for information resources and prescribing support in their roles managing care for young people with ADHD

2. The expectations and needs of young people aged 16-25 regarding primary care ADHD support, information, and management

3. Co-produce evidence informed guidance to better co-ordinate primary care for young people with ADHD, based on discussions around findings from objectives 1, 2a and 2b

OUTCOMES

The outcomes of this research will be shaped by close work with professionals and members of the community, via the practice and policy research advisory group (P-RAG) and young person and parent/carer research advisory group (Y-RAG) groups, to ensure their relevance and utility. Anticipated outcomes include:

1. National overview of primary care provision for young people with ADHD across England, including:

1. Geographic map, showing variation in provision by NHS region or appropriate organisational boundaries

2. Summary of existing care pathways for the management of young people with ADHD in primary care, including exemplars of best practice

2. Qualitative summary of the perspectives of people involved in delivering and in need of care, on the management of ADHD in primary care including:

1. Health professionals' needs for information resources and prescribing support

2. Young people with ADHD and their parent/carers' needs for information resources, healthcare, and support with self-management

3. Co-produced guidance on how to better co-ordinate and design primary care for young people aged 16-25 with ADHD.

STUDY DESIGN and METHODS Overview: This mixed methods study consists of three work packages. Each WP involves data collection/creation working with the following stakeholder groups.

• Patients, with a focus on young people (aged 16-25) with ADHD, and their parent/carers

• Health professionals, with a focus on those in primary care (including general practitioners (GPs), specialist nurses, mental health practitioners, and clinical pharmacists)

• Commissioners/providers of NHS healthcare for people with ADHD ;

Related Conditions & MeSH terms

• ADHD

• NCT number: NCT05518435
• Study type: Observational
• Source: University of Exeter
• Status: Completed
• Start date: September 28, 2022
• Completion date: March 31, 2024