Landmark new Australian ADHD Guideline sets the benchmark for diagnosis and treatment.
The world’s most up-to-date protocols for the assessment, diagnosis, and treatment of Attention Deficit Hyperactivity Disorder (ADHD) have been released in Australia.
Led by experts from organisations including Monash University’s Turner Institute for Brain and Mental Health, the Australian Evidence-Based Clinical Practice Guideline for ADHD is now live at adhdguideline.aadpa.com.au
The Australian ADHD Professionals Association (AADPA) developed the landmark document over two years via a remarkable collaboration of clinicians, researchers, and people living with ADHD.
“We want to make sure that front line clinicians have as much credible and evidence-based information as possible,” said AADPA President Professor Mark Bellgrove, who is also Turner Institute Director of Research.
For the first time, the National Health and Medical Research Council (NHMRC) has approved an ADHD Clinical Practice Guideline which has also been endorsed by major associations, college and consumer groups.
“A huge amount of work has gone into making sure that the Guideline can be adapted and used in multiple clinical settings including GPs, paediatricians, psychiatrists, psychologists, and allied health,” said Professor Bellgrove, an NHMRC Senior Research Fellow.
“The Guideline also covers families and individuals, and will be important for educators, the workplace and other areas like the justice system.”
Added Dr Tamara May, psychologist, Guideline project manager and Monash University Department of Paediatrics research affiliate: “It is important for clinicians to be providing uniform support for people with ADHD.
“People with ADHD and their families should be offered best-practice diagnosis and evidence-based treatments no matter where they are in Australia or which mental-health service they attend. The Guideline will help enable this.”
Funded by a Federal Government grant, the Guideline’s 111 clinical recommendations cover a person’s ADHD journey across their lifespan from identification and diagnosis through to an evolving support plan and information for the many people who play a supporting role.
“There’s an individual living with ADHD at the centre but there’s a whole network of family, friends, teachers and employers that need guidance and support too,” Professor Bellgrove said.
Recommendations were made by systematically reviewing the research evidence with certainty and strength of recommendations noted. Where research evidence was not found or did not meet the guideline standard, clinical consensus recommendations and clinical practice points have been made based on the expertise of the multidisciplinary guideline development group.
Guideline Co-Chair , Developmental Paediatrician Professor Katrina Williams, who is also Monash University Paediatrics Department Head and Monash Children’s Hospital Director of Research, said: “This guideline provides a great opportunity to improve care and services now, and is a much-needed foundation on which Australia can build as new evidence is generated and new knowledge from the implementation of these guidelines becomes available.”
Recommendations include:
* Clinicians being aware that some people have a higher risk of having ADHD, including those who have a close relative with ADHD, people with neurodevelopmental and mental health conditions.
* A thorough assessment is needed to make a diagnosis of ADHD, including a comprehensive clinical interview and use of rating scales and ensuring the symptoms are present in multiple settings.
* Upon diagnosis, information and support should be provided to the person and their parents/carers, including explanation of available treatment options and information about how they can minimise symptoms and maximise their strengths.
* Non-medication interventions can improve broader aspects of functioning for people with ADHD and/or their families.
* Parent/family training should be offered to parents/carers of children and adolescents with ADHD to support the family.
* Cognitive-behavioural interventions should be offered to adolescents and adults with ADHD.
* Medication interventions can improve the core symptoms of ADHD
* Clinicians and people with ADHD (or their parents/carers) should make treatment decisions together. Choice and dosage of medication must be optimised for each person.
* Ongoing monitoring is required to assess whether the medication is effective, and whether there are any unwanted effects.
* As a child with ADHD grows up, their clinicians should plan for a smooth move from health services for children to health services for adolescents, and later to adult health services.
Professor Bellgrove said the Guideline also highlighted gaps that needed to be addressed urgently.
“There’s a few areas, but one that stands out is the huge gap in our knowledge base about how ADHD presents in girls and women,” he said. “If we can detect girls with ADHD better in childhood, we have a real opportunity to change and improve lives.”
Other areas include national prescribing standards, better care pathways and involving GPs more in the diagnosis and treatment of people with ADHD. “The way the professional and lived-experience communities have come together to develop the Guideline is a watershed moment,” Professor Bellgrove said.
“The Guideline will result in better clinical care for people with ADHD; it will help reduce stigma, and stop harmful disinformation. There’s still a lot of work to be done but we’ve already started and we know the next steps we need to take.”
The digital Guideline, technical reports and other resources are at adhdguideline.aadpa.com.au
A physical version is available for $29.99 +postage (price is set at a cost recovery basis and AADPA members receive a discount)