How Effectively Are Children with ADHD Being Treated in Australia?

What you need to know

• Researchers are examining treatment patterns for Australian children with ADHD to identify potential gaps in care
• The study will link data from public mental health services with national prescription and healthcare databases
• Understanding real-world treatment patterns can help improve care and outcomes for children with ADHD

Background on ADHD treatment in Australia

Attention-deficit/hyperactivity disorder (ADHD) affects about 4% of children and adolescents in Australia. While effective treatments exist, managing ADHD can be challenging. Children often need ongoing care as they grow up, since symptoms frequently persist into adulthood.

In Australia, children with ADHD may receive treatment through public mental health services or private practitioners. Common treatments include medications like stimulants, as well as psychological therapies. However, we don’t have a clear picture of how children typically move through the healthcare system and what treatments they actually receive over time.

To address this gap, researchers are conducting a large study examining real-world treatment patterns for Australian children and teens with ADHD. They aim to track children’s care before, during, and after contact with public mental health services.

How the study will work

The researchers will gather information on children aged 5-17 who received care for ADHD or other mental health issues at public clinics in Brisbane, Melbourne, and Sydney between 2013-2020.

They will link this clinical data to national databases that track:

• Prescriptions filled through the Pharmaceutical Benefits Scheme (PBS)
• Doctor and allied health visits billed through Medicare
• Deaths recorded in the National Death Index

By combining these data sources, the researchers can map out each child’s treatment journey over many years. This includes medications prescribed, healthcare providers seen, and frequency of visits.

Key questions the study will address

The study aims to answer several important questions about ADHD treatment in Australia:

• What medications are most commonly prescribed, and in what order?
• How often do children receive psychological therapies in addition to medication?
• Do treatment approaches align with current clinical guidelines?
• Are children receiving an adequate amount of treatment over time?
• How do factors like socioeconomic status relate to the treatments children receive?
• Is there a link between treatment patterns and outcomes measured in public clinics?

Potential benefits of the research

This study will provide a comprehensive view of real-world ADHD treatment patterns that has not been available before. Some potential benefits include:

• Identifying gaps between recommended care and actual treatment received
• Understanding barriers that may prevent children from accessing adequate treatment
• Informing improvements to ADHD treatment approaches and guidelines
• Providing insights to help clinicians optimize care for individual patients

Ultimately, the goal is to ensure children with ADHD receive consistent, high-quality care to support their long-term health and development.

Treatment guidelines for ADHD

To assess how closely real-world treatment aligns with best practices, the researchers will compare the data to current clinical guidelines.

For example, the UK’s National Institute for Health and Care Excellence (NICE) recommends:

• Trying stimulant medications like methylphenidate first for most children
• Considering non-stimulant medications like atomoxetine if stimulants are ineffective or not tolerated
• Offering behavioral therapy or parent training programs, especially for young children
• Providing at least 4-8 treatment sessions, depending on the type of intervention

The study will examine whether children typically receive care that follows this stepped approach.

Challenges in treating ADHD

While guidelines provide a roadmap for ADHD treatment, managing the disorder can be complex in practice. Some key challenges include:

• High rates of other co-occurring mental health conditions
• Symptoms that change as children develop
• Difficulty maintaining consistent medication use over time
• Limited availability of behavioral therapies in some areas
• Transitions between different healthcare providers as children age

By mapping real treatment journeys, this study may reveal how these challenges play out for Australian families and where additional support is needed.

Limitations of the study

While this research will provide valuable insights, there are some limitations to keep in mind:

• It only includes children who had contact with public mental health services, not those treated entirely in private practice
• Reasons for specific treatments or changes in care may not always be clear from the data
• Information on behavioral therapies is limited to Medicare-billed sessions
• Medication data shows prescriptions filled, but not whether they were actually taken as prescribed

Despite these constraints, the study’s large scale and long-term view will significantly expand our understanding of real-world ADHD treatment patterns.

Conclusions

• This large-scale study will provide an unprecedented view of how Australian children with ADHD are treated over time
• Findings may reveal gaps between guideline recommendations and real-world care
• Results could inform efforts to improve ADHD treatment approaches and outcomes
• Similar research methods could be applied to study care for other childhood mental health conditions