Re‐audit of NICE guidance for treatment of ADHD children with methylphenidate

Abstract

Purpose

The purpose of the paper was to show that in October 2000 NICE issued guidance on the use of methylphenidate for ADHD in children. Agreed standards based on NICE guidance were finalised in May 2002 in East Kent. Authors conducted a multidisciplinary multisite audit across East Kent in 2001/2002. The audit demonstrated that practices met some of the standards but deficiencies were identified. There was also variation in practice across the region. A time bound action plan was agreed.

Design/methodology/approach

The paper aims to re‐audit the use of methylphenidate in children with ADHD and complete the audit cycle loop.

Findings

The paper finds a retrospective case notes review of children diagnosed with ADHD between 1 January and 30 June 2004 and subsequently started on short/long acting methylphenidate.

Research limitations/implications

The paper shows that a total of 58 notes were audited. Re‐audit showed an increase in the use of Conners' rating scales to 91 vs 66 percent in the previous audit. More children had their pulse and blood pressure recorded before start of medication (84 vs 51 percent). GPs, schools and parents received written information respectively in 93 vs 89 percent, 71 vs 60 percent, and 69 vs 64 percent cases at start of methylphenidate and in 69 vs 75 percent, 57 vs 53 percent, and 59 vs 57 percent cases about the most recent visit. There has been no significant change in the shared care with GPs (3 vs 4 percent). “Trial‐off” medication was considered in 82 vs 16 percent in the previous audit.

Originality/value

This paper showed improvements in some areas identified in the previous audit. Professionals still need to communicate more with those involved with the child, as this was an issue highlighted through carer involvement. Shared care arrangements with GPs continue to be an issue and work is ongoing. A new time limited action plan is being developed. There are now regular multidisciplinary ADHD team meetings and much less variation in practice across the region as a direct result of this audit.

Citation

Banerjee, S. and Venables, S. (2006), "Re‐audit of NICE guidance for treatment of ADHD children with methylphenidate", Clinical Governance: An International Journal, Vol. 11 No. 3, pp. 193-197. https://doi.org/10.1108/14777270610683128