Practice Patterns and Guideline Adherence in the Management of Attention Deficit/Hyperactivity Disorder

Abstract

Background. Current data are limited on compliance with guidelines for the treatment of attention deficit/hyperactivity disorder (ADHD). Methods. A survey assessing compliance with ADHD guidelines for diagnosis and management was distributed to pediatricians in a practice research network. Comparisons were made by practitioner characteristics. Results. In all, 42/76 surveys were returned (55%). Respondents largely adhered to American Academy of Pediatrics (AAP) guidelines. A lower percentage reported compliance for rescreening with a standardized tool (80%), use of electrocardiograms (78% rarely use), and the use of routine additional testing (80% rarely use). Academic practitioners were more likely to rescreen (100% vs 79%, P < .05). Private practitioners more often used newer therapeutic agents (7% vs 44%, P < .01). Older graduates were more comfortable diagnosing at a young age (93% vs 56%, P < .01) and were more comfortable using sleep agents (60% vs 15%, P < .01). Conclusion. Pediatricians largely adhered to AAP guidelines. These findings support changes made to the guidelines in 2011. Differences in practice patterns exist by practitioner experience, location, and practice type.