Effects of Collaborative Care for Comorbid Attention Deficit Hyperactivity Disorder Among Children With Behavior Problems in Pediatric Primary Care | Zendy

Kolko David J. | Zendy; Hart Jonathan A. | Zendy; Campo John | Zendy; Sakolsky Dara | Zendy; Rounds Jeffrey | Zendy; Wolraich Mark L. | Zendy; Wisniewski Stephen R. | Zendy

Open Access

Effects of Collaborative Care for Comorbid Attention Deficit Hyperactivity Disorder Among Children With Behavior Problems in Pediatric Primary Care

Author(s) -

Kolko David J.,

Hart Jonathan A.,

Campo John,

Sakolsky Dara,

Rounds Jeffrey,

Wolraich Mark L.,

Wisniewski Stephen R.

Publication year - 2020

Publication title -

clinical pediatrics

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 0.387

H-Index - 64

eISSN - 1938-2707

pISSN - 0009-9228

DOI - 10.1177/0009922820920013

Subject(s) - medicine , psychoeducation , referral , intervention (counseling) , attention deficit hyperactivity disorder , medical prescription , quality of life (healthcare) , psychiatry , randomized controlled trial , collaborative care , primary care , family medicine , nursing , surgery

This study evaluates the impact of a 6-month care management intervention for 206 children diagnosed with comorbid attention deficit hyperactivity disorder (ADHD) from a sample of 321 five- to 12-year-old children recruited for treatment of behavior problems in 8 pediatric primary care offices. Practices were cluster-randomized to Doctor Office Collaboration Care (DOCC) or Enhanced Usual Care (EUC). Chart reviews documented higher rates of service delivery, prescription of medication for ADHD, and titration in DOCC (vs EUC). Based on complex conditional models, DOCC showed greater acute improvement in individualized ADHD treatment goals and follow-up improvements in quality of life and ADHD and oppositional defiant disorder goals. Medication use had a significant effect on acute and follow-up ADHD symptom reduction and quality of life. Medication continuity was associated with some long-term gains. A collaborative care intervention for behavior problems that incorporated treatment guidelines for ADHD in primary care was more effective than psychoeducation and facilitated referral to community treatment.

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