Standardisation of diagnosis and treatment of ADHD is needed to ensure consistency between treatment by psychiatrists and paediatricians, according to a study in the latest Medical Journal of Australia.
Dr David Preen, Director of the Centre for Health Services Research at The University of Western Australia's School of Population Health, and his co-authors found that treatment of children with stimulant medicines for ADHD differed significantly between the two clinical specialties.
"Paediatricians treated more patients per prescriber, a greater proportion of boys, and a younger age demographic," Dr Preen says.
"Paediatricians relied less on combined psychotropic pharmacotherapy and prescribed lower stimulant doses than psychiatrists."
The authors suggest one reason the majority of children were seen by paediatricians was because referral pathways are more likely to direct child patients to paediatricians first.
Similarly, paediatricians may have treated more male patients because boys often exhibit disruptive behaviour that is more readily identified resulting in greater referral for treatment.
Differences in medication prescription between the two specialties may be because psychiatrists are more often referred children with psychiatric or behavioural disorders requiring multifaceted medication regimens.
"It is possible that the differences in prescribing medication are due to fundamental variations surrounding ADHD diagnosis and treatment as a result of differing levels of mental health training," Dr Preen says.
"A case could be made for the standardisation of diagnosis and treatment of ADHD within and between specialities."
"A state or national ADHD plan with consistency across clinical disciplines appears to have merit."
The Medical Journal of Australia
is a publication of the Australian Medical Association.