Medication management and electrocardiogram screening in children with attention deficit hyperactivity disorder
Michaela Pentony1, Zainab Ali2, Kieran Moore2
1Department of Paediatric Cardiology, Children's Health Ireland at Crumlin, Crumlin, Ireland.
Cardiology in the Young
|September 13, 2024
Summary
Routine cardiac screening for children starting attention deficit hyperactivity disorder (ADHD) medication often lacks clinical indication, leading to delays. Adhering to National Institute for Health and Care Excellence guidelines can optimize care and resources.
Area of Science:
- Pediatric Cardiology
- Neurodevelopmental Disorders
- Clinical Audit
Background:
- Cardiac screening referrals for children with attention deficit hyperactivity disorder (ADHD) medication initiation or modification are common.
- The proportion of these referrals and the detection rate of clinically significant abnormalities require quantification.
Purpose of the Study:
- To determine the percentage of referrals to cardiology for ADHD medication management.
- To assess the incidence of significant cardiac abnormalities in this patient group.
Main Methods:
- A 6-month prospective audit (November 2021-April 2022) of referrals to Crumlin Cardiology Department.
- Referrals were screened for ADHD medication-related cardiac screening and coded against National Institute for Health and Care Excellence (NICE) guidelines.
- Clinical details, abnormalities, and management were recorded.
Main Results:
- Ninety-one referrals were analyzed; 58.2% lacked a clear clinical indication.
- Only 28.5% met NICE criteria for cardiology referral.
- Of 80 reviewed cases, 90% were normal; only 1 referral (1.25%) revealed a significant abnormality, appropriate per NICE guidelines.
Conclusions:
- Unnecessary cardiac screening for ADHD medication without clinical indication causes delays and strains cardiology resources.
- Improved adherence to NICE guidelines for ADHD referrals is recommended for patient and clinician benefit.
- Targeted screening based on clinical indication is more efficient than routine pre-medication checks.
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