title: Practice patterns and guideline adherence in the management of attention deficit/hyperactivity disorder.
abstract: BACKGROUND
  Current data are limited on compliance with guidelines for the treatment of attention deficit/hyperactivity disorder (ADHD).
  
  
  METHODS
  A survey assessing compliance with ADHD guidelines for diagnosis and management was distributed to pediatricians in a practice research network. Comparisons were made by practitioner characteristics.
  
  
  RESULTS
  In all, 42/76 surveys were returned (55%). Respondents largely adhered to American Academy of Pediatrics (AAP) guidelines. A lower percentage reported compliance for rescreening with a standardized tool (80%), use of electrocardiograms (78% rarely use), and the use of routine additional testing (80% rarely use). Academic practitioners were more likely to rescreen (100% vs 79%, P < .05). Private practitioners more often used newer therapeutic agents (7% vs 44%, P < .01). Older graduates were more comfortable diagnosing at a young age (93% vs 56%, P < .01) and were more comfortable using sleep agents (60% vs 15%, P < .01).
  
  
  CONCLUSIONS
  Pediatricians largely adhered to AAP guidelines. These findings support changes made to the guidelines in 2011. Differences in practice patterns exist by practitioner experience, location, and practice type.
authors: Medical University of South Carolina, Charleston, SC, USA mcellig@musc.edu.
authors: James T
authors: JT
authors: McElligott
authors: Medical University of South Carolina, Charleston, SC, USA.
authors: John R
authors: JR
authors: Lemay
authors: Medical University of South Carolina, Charleston, SC, USA.
authors: Elizabeth S
authors: ES
authors: O'Brien
authors: Medical University of South Carolina, Charleston, SC, USA.
authors: Virginia A
authors: VA
authors: Roland
authors: Medical University of South Carolina, Charleston, SC, USA.
authors: William T
authors: WT
authors: Basco
authors: Medical University of South Carolina, Charleston, SC, USA.
authors: James R
authors: JR
authors: Roberts
mesh_terms: D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D002648:Child; D004562:Electrocardiography / Q000706:statistics & numerical data; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006306:Health Surveys; D006801:Humans; D008297:Male; D010372:Pediatrics; D010819:Physician's Role; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012424:Rural Population / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data
chemical_list: D000697:Central Nervous System Stimulants
keywords: attention deficit/hyperactivity disorder; behavioral issues; hyperactivity; medications; stimulant medications