core principles of quality ADHD care

These core principles of quality ADHD care, as defined by the Continuum Steering Committee, form the backbone of their approach to ADHD treatment and Continuum‘s CME activities.

The nature of ADHD

  • Clinicians should be aware that ADHD is a familial neurodevelopmental condition, associated with a range of clinical and psychosocial impairments whose effects often persist throughout the lifespan of the individual, requiring treatment whenever symptoms cause impairment.

 

Diagnosis

  • Clinicians should be aware of the available screening and diagnostic tools and be confident in using them during a clinical interview to diagnose age-appropriate ADHD and determine impairment severity.
  • Clinicians should be skilled at recognising ADHD and confident in differentiating between it and common comorbid conditions, which may mask or mimic it. Treatment should be adapted to manage ADHD alongside comorbidities, and should evolve with the changing needs of the patient.

 

Therapeutic alliance

  • The therapeutic alliance between clinicians, patients and their families is a crucial aspect of treatment that aids diagnosis, side-effect monitoring and treatment efficacy.
  • Clinicians should build trusting and open relationships with patients and their families, and provide psychoeducation to enable them to understand the condition fully and make informed treatment choices.

 

Setting goals

  • All treatment and treatment goals should be joint decisions between clinicians, patients and their families, and should evolve with the patient and their changing needs.
  • Treatment goals should be realistic and reflective of clinical and cognitive impairment, and comorbid conditions.

 

Treatment

  • Treatment should be comprehensive, consisting of psychoeducation, psychosocial care and, where appropriate, pharmacotherapy. It should be individualised, and regularly reviewed and adapted to match the evolving condition and changing treatment goals.
  • Patients should receive regular monitoring and assessment to minimise side effects and maximise treatment efficacy for both pharmacotherapy and psychosocial interventions.
  • Treatment should continue for as long as symptoms persist, and decisions to discharge patients from treatment should not be based on age, but clinical progress and patient agreement.