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Support for primary care prescribing for adult ADHD in England: national survey

Price, Anna; Becker, Kieran; Ward, John; Ukoumunne, Obioha; Gudka, Rebecca; Salimi, Anita; Mughal, Faraz; Melendez-Torres, G J; Smith, Jane; Newlove-Delgado, Tamsin

Authors

Anna Price

Kieran Becker

John Ward

Obioha Ukoumunne

Rebecca Gudka

Anita Salimi

G J Melendez-Torres

Jane Smith

Tamsin Newlove-Delgado



Abstract

Background: Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder with effective pharmacological treatments that improve symptoms and reduce complications. NICE guidelines recommend primary care practitioners prescribe medication for adult ADHD under shared care agreements with adult mental health services (AMHS). However, provision remains uneven, with some practitioners reporting a lack of support. Aim: This study aimed to describe supportive elements (prescribing, shared care, AMHS availability) of primary care prescribing for adult ADHD medication in England, to inform service improvement and improve access for this underserved population. Design and Setting: Three interlinked cross-sectional surveys asked every integrated care board (ICB) in England (Commissioners), and convenience samples of healthcare professionals (HP) and people with lived experience (LE), about elements supporting pharmacological treatment of ADHD in primary care. Method: Descriptive analyses used percentages and confidence intervals to summarise responses by stakeholder group. Variations in reported provision and practice were explored and displayed visually using mapping software. Results: Data from 782 respondents (42 Commissioners; 331 HP; 409 LE) revealed differences in reported provision by stakeholder group, including for prescribing (94.6% of HP vs 62.6% of LE). Over 40% of respondents reported extended AMHS waiting times of two years or more. There was some variability by NHS region, for example London had highest rates of HP reported prescribing (100%), and lowest reported extended waiting times (25.0%). Conclusion: Elements supporting appropriate shared care prescribing of ADHD medication via primary care are not universally available in England. Co-ordinated approaches are needed to address these gaps.

Citation

Price, A., Becker, K., Ward, J., Ukoumunne, O., Gudka, R., Salimi, A., …Newlove-Delgado, T. (in press). Support for primary care prescribing for adult ADHD in England: national survey. British Journal of General Practice (BJGP), BJGP.2023.0595. https://doi.org/10.3399/BJGP.2023.0595

Journal Article Type Article
Acceptance Date Apr 9, 2024
Online Publication Date Apr 15, 2024
Deposit Date Apr 27, 2024
Publicly Available Date Apr 29, 2024
Journal British Journal of General Practice
Print ISSN 0960-1643
Electronic ISSN 1478-5242
Publisher Royal College of General Practitioners
Peer Reviewed Peer Reviewed
Pages BJGP.2023.0595
DOI https://doi.org/10.3399/BJGP.2023.0595
Public URL https://keele-repository.worktribe.com/output/800273

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Licence
https://creativecommons.org/licenses/by/4.0/

Publisher Licence URL
https://creativecommons.org/licenses/by/4.0/

Copyright Statement
© 2024 The Author(s). This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License (http://creativecommons.org/licenses/by/4.0/). Published by British Journal of General Practice. For editorial process and policies, see: https://bjgp.org/authors/bjgp-editorial-process-and-policies





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