Skip to main content

Advertising Disclaimer »

Main menu

  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors/Reviewers
    • Submit Manuscript
    • Author Guidelines
    • Reviewer Guidelines
    • Open Access
    • Editorial Policies
  • Content
    • Current Issue
    • Online First
    • Archive
    • Blogs
    • Topic/Program Collections
    • AAP Meeting Abstracts
  • Pediatric Collections
    • COVID-19
    • Racism and Its Effects on Pediatric Health
    • More Collections...
  • AAP Policy
  • Supplements
    • Supplements
    • Publish Supplement
  • Multimedia
    • Video Abstracts
    • Pediatrics On Call Podcast
  • Subscribe
  • Alerts
  • Careers
  • Other Publications
    • American Academy of Pediatrics

User menu

  • Log in
  • My Cart

Search

  • Advanced search
American Academy of Pediatrics

AAP Gateway

Advanced Search

AAP Logo

  • Log in
  • My Cart
  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors/Reviewers
    • Submit Manuscript
    • Author Guidelines
    • Reviewer Guidelines
    • Open Access
    • Editorial Policies
  • Content
    • Current Issue
    • Online First
    • Archive
    • Blogs
    • Topic/Program Collections
    • AAP Meeting Abstracts
  • Pediatric Collections
    • COVID-19
    • Racism and Its Effects on Pediatric Health
    • More Collections...
  • AAP Policy
  • Supplements
    • Supplements
    • Publish Supplement
  • Multimedia
    • Video Abstracts
    • Pediatrics On Call Podcast
  • Subscribe
  • Alerts
  • Careers

Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
Article

Variability in ADHD Care in Community-Based Pediatrics

Jeffery N. Epstein, Kelly J. Kelleher, Rebecca Baum, William B. Brinkman, James Peugh, William Gardner, Phil Lichtenstein and Joshua Langberg
Pediatrics December 2014, 134 (6) 1136-1143; DOI: https://doi.org/10.1542/peds.2014-1500
Jeffery N. Epstein
aDepartment of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kelly J. Kelleher
bDepartment of Pediatrics, Nationwide Children’s Hospital, Columbus, Ohio;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Rebecca Baum
bDepartment of Pediatrics, Nationwide Children’s Hospital, Columbus, Ohio;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
William B. Brinkman
aDepartment of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
James Peugh
aDepartment of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
William Gardner
bDepartment of Pediatrics, Nationwide Children’s Hospital, Columbus, Ohio;
cDepartment of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada;
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Phil Lichtenstein
dThe Children’s Home of Cincinnati, Cincinnati, Ohio; and
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Joshua Langberg
eDepartment of Psychology, Virginia Commonwealth University, Richmond, Virginia
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info & Metrics
  • Comments
Loading

This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. Access to this article can also be purchased.

Download PDF

Abstract

BACKGROUND: Although many efforts have been made to improve the quality of care delivered to children with attention-deficit/hyperactivity disorder (ADHD) in community-based pediatric settings, little is known about typical ADHD care in these settings other than rates garnered through pediatrician self-report.

METHODS: Rates of evidence-based ADHD care and sources of variability (practice-level, pediatrician-level, patient-level) were determined by chart reviews of a random sample of 1594 patient charts across 188 pediatricians at 50 different practices. In addition, the associations of Medicaid-status and practice setting (ie, urban, suburban, and rural) with the quality of ADHD care were examined.

RESULTS: Parent- and teacher-rating scales were used during ADHD assessment with approximately half of patients. The use of Diagnostic and Statistical Manual of Mental Disorders criteria was documented in 70.4% of patients. The vast majority (93.4%) of patients with ADHD were receiving medication and only 13.0% were receiving psychosocial treatment. Parent- and teacher-ratings were rarely collected to monitor treatment response or side effects. Further, fewer than half (47.4%) of children prescribed medication had contact with their pediatrician within the first month of prescribing. Most variability in pediatrician-delivered ADHD care was accounted for at the patient level; however, pediatricians and practices also accounted for significant variability on specific ADHD care behaviors.

CONCLUSIONS: There is great need to improve the quality of ADHD care received by children in community-based pediatric settings. Improvements will likely require systematic interventions at the practice and policy levels to promote change.

  • attention deficit and disruptive behavior disorders
  • pediatrics
  • behavioral medicine
  • guidelines
  • quality
  • Accepted September 11, 2014.
  • Copyright © 2014 by the American Academy of Pediatrics

Individual Login

Log in
You will be redirected to aap.org to login or to create your account.

Institutional Login

via Institution

You may be able to gain access using your login credentials for your institution. Contact your librarian or administrator if you do not have a username and password.

Log in through your institution

If your organization uses OpenAthens, you can log in using your OpenAthens username and password. To check if your institution is supported, please see this list. Contact your library for more details.

Purchase access

You may purchase access to this article. This will require you to create an account if you don't already have one.

Offer Reprints

PreviousNext
Back to top

Advertising Disclaimer »

In this issue

Pediatrics
Vol. 134, Issue 6
1 Dec 2014
  • Table of Contents
  • Index by author
View this article with LENS
PreviousNext
Email Article

Thank you for your interest in spreading the word on American Academy of Pediatrics.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Variability in ADHD Care in Community-Based Pediatrics
(Your Name) has sent you a message from American Academy of Pediatrics
(Your Name) thought you would like to see the American Academy of Pediatrics web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Request Permissions
Article Alerts
Log in
You will be redirected to aap.org to login or to create your account.
Or Sign In to Email Alerts with your Email Address
Citation Tools
Variability in ADHD Care in Community-Based Pediatrics
Jeffery N. Epstein, Kelly J. Kelleher, Rebecca Baum, William B. Brinkman, James Peugh, William Gardner, Phil Lichtenstein, Joshua Langberg
Pediatrics Dec 2014, 134 (6) 1136-1143; DOI: 10.1542/peds.2014-1500

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Share
Variability in ADHD Care in Community-Based Pediatrics
Jeffery N. Epstein, Kelly J. Kelleher, Rebecca Baum, William B. Brinkman, James Peugh, William Gardner, Phil Lichtenstein, Joshua Langberg
Pediatrics Dec 2014, 134 (6) 1136-1143; DOI: 10.1542/peds.2014-1500
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
Print
Download PDF
Insight Alerts
  • Table of Contents

Jump to section

  • Article
    • Abstract
    • Methods
    • Results
    • Discussion
    • Conclusions
    • Footnotes
    • References
  • Figures & Data
  • Info & Metrics
  • Comments

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Pediatric Attention-Deficit/Hyperactivity Disorder in Louisiana: Trends, Challenges, and Opportunities for Enhanced Quality of Care
  • Predictors of Medication Continuity in Children With ADHD
  • ADHD: Overdiagnosed and overtreated, or misdiagnosed and mistreated?
  • Preschool ADHD Diagnosis and Stimulant Use Before and After the 2011 AAP Practice Guideline
  • Impact of a Web-Portal Intervention on Community ADHD Care and Outcomes
  • Ten-Year Trends In Treatment Services For Children With Attention Deficit Hyperactivity Disorder Enrolled In Medicaid
  • Variations in Mental Health Diagnosis and Prescribing Across Pediatric Primary Care Practices
  • Improving Care for Children With ADHD: The Information is Just a Rating Scale Away
  • Timing of the Diagnosis of Attention-Deficit/Hyperactivity Disorder and Autism Spectrum Disorder
  • Collaborative Care for Children With ADHD Symptoms: A Randomized Comparative Effectiveness Trial
  • Cost Saving and Quality of Care in a Pediatric Accountable Care Organization
  • Google Scholar

More in this TOC Section

  • Health Outcomes in Young Children Following Pertussis Vaccination During Pregnancy
  • Rural-Urban Differences in Changes and Effects of Tobacco 21 in Youth E-cigarette Use
  • Neonatal SARS-CoV-2 Infections in Breastfeeding Mothers
Show more Article

Similar Articles

Subjects

  • Developmental/Behavioral Pediatrics
    • Developmental/Behavioral Pediatrics
    • Attention-Deficit/Hyperactivity Disorder (ADHD)

Keywords

  • attention deficit and disruptive behavior disorders
  • pediatrics
  • behavioral medicine
  • guidelines
  • quality
  • Journal Info
  • Editorial Board
  • Editorial Policies
  • Overview
  • Licensing Information
  • Authors/Reviewers
  • Author Guidelines
  • Submit My Manuscript
  • Open Access
  • Reviewer Guidelines
  • Librarians
  • Institutional Subscriptions
  • Usage Stats
  • Support
  • Contact Us
  • Subscribe
  • Resources
  • Media Kit
  • About
  • International Access
  • Terms of Use
  • Privacy Statement
  • FAQ
  • AAP.org
  • shopAAP
  • Follow American Academy of Pediatrics on Instagram
  • Visit American Academy of Pediatrics on Facebook
  • Follow American Academy of Pediatrics on Twitter
  • Follow American Academy of Pediatrics on Youtube
  • RSS
American Academy of Pediatrics

© 2021 American Academy of Pediatrics