The Online Journal of Clinical Audits, Vol 2, No 2 (2010)

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Drug Treatment for Attention Deficit Hyperactivity Disorder (ADHD)

Richard Soppitt, John Watts, Amanda J Fuller


Aims:  To compare current practice with updated NICE guidelines (2008).


Methods:  All patients on ADHD medication currently or in the past 6 months were included from 2 Consultant Psychiatrists.  A questionnaire was compiled to evaluate areas of practice that meet the current standards and to identify areas of improvement.


Results:  38 cases were identified.  Consultant psychiatrists diagnosed all new ADHD cases.  All patients were treated using monotherapy initially – either methylphenidate or atomoxetine according to the guidelines.  The service was close to fully complying with monitoring height and weight whilst initiating medication.  There was zero compliance with the new recommendations of monitoring blood pressure and heart rate before and after each dose alteration.


Conclusions:  Areas for improvement included the new recommendations of increased monitoring of blood pressure (BP) and heart rate (HR) before and after each dose and improving recording clinical decisions.   Clinicians involved in the audit have discussed the importance of recording clinical decisions and ways in which the MDT/GP can be involved particularly in the initial monitoring of drug treatment.


Recommendations:  The team agreed to consider using a template for drug monitoring and to insert BP centile charts into the notes to record clinical details.  The team will be informed of the results and recommendations.

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