Shared Care Models in the Treatment of Pediatric Attention-Deficit/Hyperactivity Disorder (ADHD)

Objectives: The aim of this review is to evaluate the effectiveness of shared/collaborative care between mental health-care providers and primary care providers (PCPs) on the outcomes of children and adolescents with attention-deficit/hyperactivity disorder (ADHD). This evaluation will be very helpf...

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Main Authors: Meshal A. Sultan, Carlos S. Pastrana, Kathleen A. Pajer
Format: Article
Language:English
Published: SAGE Publishing 2018-03-01
Series:Health Services Research & Managerial Epidemiology
Online Access:https://doi.org/10.1177/2333392818762886
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spelling doaj-568743db1f9042bea3bcf5cc13eefb032020-11-25T02:34:09ZengSAGE PublishingHealth Services Research & Managerial Epidemiology2333-39282018-03-01510.1177/2333392818762886Shared Care Models in the Treatment of Pediatric Attention-Deficit/Hyperactivity Disorder (ADHD)Meshal A. Sultan0Carlos S. Pastrana1Kathleen A. Pajer2 Mental Health Center of Excellence, Al Jalila Children’s Specialty Hospital, Dubai, United Arab Emirates Neuroscience and Mental Health, Carleton University, Ottawa, Ontario, Canada Children’s Hospital of Eastern Ontario (CHEO), Ottawa, Ontario, CanadaObjectives: The aim of this review is to evaluate the effectiveness of shared/collaborative care between mental health-care providers and primary care providers (PCPs) on the outcomes of children and adolescents with attention-deficit/hyperactivity disorder (ADHD). This evaluation will be very helpful in the allocation of ADHD resources for models with the strongest evidence. Methods: Using the Preferred Reporting Items for Systematic Review and Meta-analysis statement, we searched for randomized controlled trials, cohort, case–control, and cross-sectional studies on shared/collaborative care models in the treatment of ADHD. Using MEDLINE, PsycINFO, and CENTRAL databases from January 2000 to December 2016, we retrieved English language articles for review. The validation search identified 75 records. Five studies met the inclusion criteria and were analyzed in this systematic review. There were insufficient data for a meta-analysis. The included studies involved 655 children and adolescents who had a diagnosis of ADHD. The Cochrane Collaboration’s tool for assessing risk of bias was used to estimate bias. Results: Overall, the results show that the effects of shared/collaborative care models were small to moderate (effect size: 0.1-0.6, P = .04) on symptom rating scales, but all positively affected functional outcomes (effect size: 0.3-0.7, P = .04-.01). The data indicated that the models were associated with increased PCPs’ comfort levels, but the evidence for increased capacity for diagnosing and managing ADHD was weaker. Conclusions: This review concludes that the current studies do not show strong evidence for the outcome of collaboration between PCPs and mental health professionals on ADHD management. Future research should consider providing education to PCPs on management guidelines prior to conducting the trials, and more innovation is needed to discover methods of collaboration that affect the direct care of ADHD.https://doi.org/10.1177/2333392818762886
collection DOAJ
language English
format Article
sources DOAJ
author Meshal A. Sultan
Carlos S. Pastrana
Kathleen A. Pajer
spellingShingle Meshal A. Sultan
Carlos S. Pastrana
Kathleen A. Pajer
Shared Care Models in the Treatment of Pediatric Attention-Deficit/Hyperactivity Disorder (ADHD)
Health Services Research & Managerial Epidemiology
author_facet Meshal A. Sultan
Carlos S. Pastrana
Kathleen A. Pajer
author_sort Meshal A. Sultan
title Shared Care Models in the Treatment of Pediatric Attention-Deficit/Hyperactivity Disorder (ADHD)
title_short Shared Care Models in the Treatment of Pediatric Attention-Deficit/Hyperactivity Disorder (ADHD)
title_full Shared Care Models in the Treatment of Pediatric Attention-Deficit/Hyperactivity Disorder (ADHD)
title_fullStr Shared Care Models in the Treatment of Pediatric Attention-Deficit/Hyperactivity Disorder (ADHD)
title_full_unstemmed Shared Care Models in the Treatment of Pediatric Attention-Deficit/Hyperactivity Disorder (ADHD)
title_sort shared care models in the treatment of pediatric attention-deficit/hyperactivity disorder (adhd)
publisher SAGE Publishing
series Health Services Research & Managerial Epidemiology
issn 2333-3928
publishDate 2018-03-01
description Objectives: The aim of this review is to evaluate the effectiveness of shared/collaborative care between mental health-care providers and primary care providers (PCPs) on the outcomes of children and adolescents with attention-deficit/hyperactivity disorder (ADHD). This evaluation will be very helpful in the allocation of ADHD resources for models with the strongest evidence. Methods: Using the Preferred Reporting Items for Systematic Review and Meta-analysis statement, we searched for randomized controlled trials, cohort, case–control, and cross-sectional studies on shared/collaborative care models in the treatment of ADHD. Using MEDLINE, PsycINFO, and CENTRAL databases from January 2000 to December 2016, we retrieved English language articles for review. The validation search identified 75 records. Five studies met the inclusion criteria and were analyzed in this systematic review. There were insufficient data for a meta-analysis. The included studies involved 655 children and adolescents who had a diagnosis of ADHD. The Cochrane Collaboration’s tool for assessing risk of bias was used to estimate bias. Results: Overall, the results show that the effects of shared/collaborative care models were small to moderate (effect size: 0.1-0.6, P = .04) on symptom rating scales, but all positively affected functional outcomes (effect size: 0.3-0.7, P = .04-.01). The data indicated that the models were associated with increased PCPs’ comfort levels, but the evidence for increased capacity for diagnosing and managing ADHD was weaker. Conclusions: This review concludes that the current studies do not show strong evidence for the outcome of collaboration between PCPs and mental health professionals on ADHD management. Future research should consider providing education to PCPs on management guidelines prior to conducting the trials, and more innovation is needed to discover methods of collaboration that affect the direct care of ADHD.
url https://doi.org/10.1177/2333392818762886
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