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Comparison of Attention‐Deficit/Hyperactivity Disorder Care Between School‐Based Health Centers and a Continuity Clinic
Author(s) -
MacGeorge Claire A.,
King Kathryn L.,
Simpson Annie N.,
Abramson Erika L.,
Bundy David G.,
McElligott James T.
Publication year - 2019
Publication title -
journal of school health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.851
H-Index - 86
eISSN - 1746-1561
pISSN - 0022-4391
DOI - 10.1111/josh.12836
Subject(s) - medicine , guideline , confidence interval , relative risk , attention deficit hyperactivity disorder , continuity of care , logistic regression , pediatrics , health care , psychiatry , pathology , economics , economic growth
ABSTRACT BACKGROUND School‐based health centers (SBHC) are in a unique position to provide guideline‐driven attention‐deficit/hyperactivity disorder (ADHD) care. In this study, we compared adherence to 2 components of ADHD guidelines in SBHC versus a continuity clinic. METHODS We compared proportions of ADHD visits that had a structured symptom report available and timely follow‐up in SBHC to a continuity clinic using chart review. We used multiple logistic regression to estimate the association between guideline adherence and clinic type. RESULTS Participants who had a medication dose change were 3.9 times more likely (relative risk [RR] = 3.9, 95% confidence interval [CI] 3.0‐5.1) to have a structured report present and 1.7 times more likely (RR = 1.7, 95% CI 1.2‐2.2) to have follow‐up within 30 days if they were seen in SBHC versus continuity clinic. Participants who were stable on their medication dose were 18 times more likely (RR = 18.0, 95% CI 11.3‐29.0) to have a structured report present and 1.4 times more likely (RR = 1.4, 95% CI 1.3‐1.6) to have follow‐up within 100 days if they were seen in SBHC versus continuity clinic. CONCLUSIONS Care provided in SBHC was associated with improved adherence to guidelines and has the potential to the improve pediatric ADHD outcomes.