Approaching ADHD as a chronic condition: implications for long-term adherence.
Attention-deficit/hyperactivity disorder (ADHD) is one of the most common chronic conditions of childhood. Although evidence-based treatments for ADHD, including stimulant medication and behavior modification, have long been established, and guidelines for care of ADHD in primary care settings have been developed, adherence to long-term therapy is poor among youth with ADHD. This article proposes use of the Chronic Care Model for Child Health, the purpose of which is to develop informed, activated patients who will interact with a prepared, proactive health care team. Six "pillars" make up the model: decision support, delivery system design, clinical information systems, family and self-management support, community resources and policies, and health care organizations. Each of these is discussed, and an individual example is described. Adopting the Chronic Care Model for Child Health has the potential to improve the quality of care for ADHD.
Van Cleave
Jeanne
J
Center for Child and Adolescent Health Policy, Massachusetts General Hospital for Children, Boston, Massachusetts, USA.
Leslie
Laurel K
LK
D001289:Attention Deficit Disorder with Hyperactivity / Q000523:psychology / Q000628:therapy; D002648:Child; D002665:Child Psychiatry / Q000458:organization & administration; D002908:Chronic Disease; D003256:Community Participation; D003266:Continuity of Patient Care; D020000:Decision Support Systems, Clinical; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008134:Long-Term Care / Q000458:organization & administration*; D016294:Models, Nursing; D017146:Models, Organizational; D010348:Patient Care Team / Q000458:organization & administration*; D010349:Patient Compliance / Q000523:psychology*; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000458:organization & administration*; D011568:Psychiatric Nursing / Q000458:organization & administration; D002666:Psychology, Child; D012017:Referral and Consultation; D012944:Social Support; D017749:Total Quality Management / Q000458:organization & administration