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Effects of Collaborative Care for Comorbid Attention Deficit Hyperactivity Disorder Among Children With Behavior

David J Kolko1, Jonathan A Hart2, John Campo3

  • 1University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

Clinical Pediatrics
|June 7, 2020
PubMed

Insights

A 6-month collaborative care intervention improved ADHD treatment and quality of life for children. This approach, integrating ADHD guidelines in primary care, surpassed standard care and referrals.

Area of Science:

  • Pediatric Primary Care
  • Behavioral Health Integration
  • Child Psychology

Background:

  • Attention Deficit Hyperactivity Disorder (ADHD) and oppositional defiant disorder are common in children.
  • Effective management of these conditions in primary care settings is crucial.
  • Existing care models may not fully address the complexities of comorbid behavioral issues.

Purpose of the Study:

  • To evaluate a 6-month collaborative care intervention for children with ADHD and behavior problems.
  • To compare the Doctor Office Collaboration Care (DOCC) model with Enhanced Usual Care (EUC).
  • To assess the impact on treatment delivery, symptom reduction, and quality of life.

Main Methods:

  • Cluster-randomized trial in 8 pediatric primary care offices.
  • Involved 321 children aged 5-12 with behavior problems, 206 diagnosed with ADHD.
  • Intervention group received DOCC; control group received EUC.

Main Results:

  • DOCC demonstrated higher rates of service delivery, ADHD medication prescription, and titration.
  • DOCC showed greater acute improvement in ADHD treatment goals and follow-up gains in quality of life.
  • Medication use significantly impacted ADHD symptom reduction and quality of life; continuity yielded long-term benefits.

Conclusions:

  • Collaborative care incorporating ADHD treatment guidelines in primary care is more effective than standard care.
  • The DOCC model improved ADHD management and patient outcomes.
  • Integrated care approaches enhance the treatment of behavioral problems in pediatric settings.

Keywords:
clinical trialscollaborative careintegrated carepediatric care integrationtreatment of ADHD

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