title: Follow-up care of children identified with ADHD by primary care clinicians: A prospective cohort study.
abstract: OBJECTIVE
  To document follow-up care received by children identified with attention deficit hyperactivity disorder (ADHD) by primary care clinicians (PCCs).
  
  
  METHODS
  We surveyed families of children 4 to 15 years of age who had been diagnosed with ADHD. At an index office visit, parents and clinicians completed questionnaires. Six months after the index visit, parents completed a questionnaire (N = 659 returned surveys, 68% return rate). The main outcome measure was the number of visits with the patients' PCCs or mental health specialists during the 6 months after the index visit.
  
  
  RESULTS
  Children had a median of one visit PCC over a period of 6 months. Children who had prescriptions for psychotropic medications (78%) did not differ from others in the number of visits. Follow-up visits with the child's own doctor were more common when the PCC had completed mental health training. Only 26% of patients saw a mental health specialist. Children who were black, on Medicaid, or with higher levels of internalizing symptoms were more likely to see a mental health specialist.
  
  
  CONCLUSIONS
  Children treated for ADHD need more follow-up visits to permit adjustment of medication and support continuation of patients in treatment. Systematic quality improvement efforts are warranted.
authors.affiliation: Children's Research Institute and the Department of Pediatrics, Ohio State University, Columbus, Ohio, USA. gardnersw@pediatrics.ohio-state.edu
authors.forename: William
authors.initials: W
authors.lastname: Gardner
authors.forename: Kelly J
authors.initials: KJ
authors.lastname: Kelleher
authors.forename: Kathleen
authors.initials: K
authors.lastname: Pajer
authors.forename: John V
authors.initials: JV
authors.lastname: Campo
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D001521:Behavior Therapy; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome