Primary care treatment of attention-deficit/hyperactivity disorder

Primary care physicians should consider the role of families of patients with attention-deficit/ hyperactivity disorder (ADHD) not just in terms of their genetic relationship but also in terms of the role family can play in assisting in the treatment and management of the disorder. When first encountering a new case of ADHD, primary care physicians should confirm the diagnosis, identify comorbidities and other primary disorders, and develop a comprehensive assessment of the patient with ADHD that includes consideration of family-related influences. Management of multiple medical, mental health, and psychosocial problems over time will often be ineffective if ADHD is not adequately managed. The most effective management should be multimodal, with patients benefiting from caring professionals with special expertise in the treatment of ADHD as well as the primary care physician. Successful management of ADHD begins with establishing a therapeutic alliance with the patient and affected family that includes patient and family education and agreement on patient-specific goals, treatment, follow-up, and monitoring. As pharmacotherapy controls the core symptoms of ADHD, the primary care physician and treatment team should discuss with the patient other supportive interventions.