title: Practitioner characteristics and the treatment of children and adolescents with attention deficit hyperactivity disorder.
abstract: OBJECTIVE
  To investigate whether recent Australian practice conforms to the draft 2009 National Health and Medical Research Council (NHMRC) guidelines on the management of attention deficit hyperactivity disorder.
  
  
  METHODS
  Data from the 2007 Special Review on Attention Deficit Hyperactivity Disorder in Children and Adolescents in New South Wales (NSW) were examined.
  
  
  RESULTS
  Two hundred seven approved stimulant prescribers in NSW responded to a detailed survey on treatment practice (including 121 paediatricians and 67 psychiatrists). Overall, the practice identified in this survey of NSW approved stimulant prescribers was consistent with that recommended in the draft NHMRC guidelines. Paediatricians were more likely to inform families of developmental therapies. Most prescribers (67%) considered stimulants to be the first line of treatment for at least half of their patients. Psychiatrists were more likely to use stimulants as first-line treatments, while those recently qualified were less likely to prescribe. Half of the prescribers were willing to consider prescribing for children 4 years of age and younger. Paediatricians were more likely to consider prescribing to this age group, while those recently qualified were less likely. There were no significant differences in prescribing practice between child and adult psychiatrists. Most prescribers (67-97%) routinely monitored patients on stimulants for weight, height, blood pressure and academic progress. Psychiatrists were less likely to review these parameters than paediatricians, with this difference being largely due to adult psychiatrists.
  
  
  CONCLUSIONS
  There are significant differences in prescribing practice between paediatricians and psychiatrists. These variations may reflect differing training programs and patient populations, and merit close consideration in any review arising from the publication of the recent NHMRC guideline.
authors: School of Psychiatry, University of New South Wales, Prince of Wales Hospital, Hospital Road, Randwick, New South Wales, Australia. phil.mitchell@unsw.edu.au
authors: Philip B
authors: PB
authors: Mitchell
authors: Florence
authors: F
authors: Levy
authors: Dusan
authors: D
authors: Hadzi-Pavlovic
authors: Patrick E
authors: PE
authors: Concannon
authors: Paul
authors: P
authors: Hutchins
authors: Desmond L
authors: DL
authors: Mulcahy
authors: Simon D
authors: SD
authors: Clarke
authors: Pia A
authors: PA
authors: Salmelainen
authors: Alexandra
authors: A
authors: Warner
authors: Clifford F
authors: CF
authors: Hughes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001289:Attention Deficit Disorder with Hyperactivity / Q000628:therapy*; D001521:Behavior Therapy / Q000706:statistics & numerical data; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D002648:Child; D003131:Combined Modality Therapy / Q000706:statistics & numerical data; D016903:Drug Monitoring / Q000706:statistics & numerical data; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009517:New South Wales; D010372:Pediatrics / Q000592:standards / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011570:Psychiatry / Q000592:standards / Q000706:statistics & numerical data
chemical_list: D000697:Central Nervous System Stimulants