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Can a Continuing Medical Education Intervention Change Pediatricians' Attention-Deficit/Hyperactivity Disorder

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Continuing medical education (CME) programs improve primary care clinicians' use of attention-deficit/hyperactivity disorder (ADHD) evidence-based practices. Care manager support enhanced some, but not all, practice changes.

Keywords:
ADHDcontinuing medical educationevidence-based practicesintegrated behavior healththeory of reasoned action

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Area of Science:

  • Medical Education
  • Pediatric Psychiatry
  • Clinical Practice Improvement

Background:

  • Primary care clinicians (PCCs) face challenges in implementing evidence-based practices (EBPs) for attention-deficit/hyperactivity disorder (ADHD).
  • Continuing medical education (CME) and care manager (CM) support are potential strategies to improve ADHD diagnostics and treatment in primary care settings.

Purpose of the Study:

  • To evaluate the impact of a 6-month CME program on PCCs' adoption of ADHD EBPs.
  • To determine if randomly assigned CM support further enhances practice changes initiated by the CME program.

Main Methods:

  • 47 PCCs participated in a 3-day CME training, with half receiving additional CM support.
  • Chart reviews of 182 ADHD cases before and after the intervention assessed 9 EBP variables.
  • Mixed-effects regression analyses examined the effects of CME and CM support on practice changes.

Main Results:

  • Six of nine ADHD EBP variables significantly improved post-CME, including diagnostic rating scales and side effect monitoring.
  • CM support showed additive benefits for three EBP variables but did not impact others like follow-up visit frequency or medication adjustments.
  • The CME program demonstrated sustained positive effects on PCCs' ADHD EBP implementation.

Conclusions:

  • Intensive CME programs can drive objective and lasting improvements in PCCs' clinical practices for ADHD.
  • CM support can augment CME effectiveness for specific practice behaviors, but further research is needed to optimize interventions.
  • Tailored educational and support strategies are crucial for comprehensive EBP integration in ADHD management.