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Adult ADHD outcome audit based on NICE guidelines

Moshieve Febin Edwin (Clinical Lead Adult ADHD Service, based at Tees Esk And Wear Valleys NHS Foundation Trust, Spennymoor, UK)

Advances in Mental Health and Intellectual Disabilities

ISSN: 2044-1282

Article publication date: 26 August 2014



Adult ADHD is a neuro-developmental disorder. The current prevalence of ADHD in adults is around 1.9-4 per cent. The service for adults with ADHD based on NICE guideline recommendation. Hence, the author decides to audit the Adult ADHD case loads against the gold standard set by the NICE. The paper aims to discuss these issues.


The study was based on a retrospective analysis and collection of data from electronic patient records for a duration of five months between October 2011 and February 2012. The data findings were matched against the NICE standards. There were 15 standards identified. On top of that we used six service outcome questions to improve the Quality of the service provided.


As the service outcomes were set for 100 per cent, the performance fell short in few areas. The service managed to achieve roughly 80-95 per cent in areas such as medication monitoring, transition service and care plan with shared care guidelines for prescription in primary care. The service under performed in areas on non-pharmacological interventions such as cognitive-behavioural therapy (CBT). The service continues to provide a exceptional service for adults with intellectual disability and ADHD.

Research limitations/implications

The research was limited by information and recall bias due to the retrospective nature of data analysis. There was also over representation of the numbers in co-morbid cases due to more than two diagnosis.

Practical implications

The paper outlines the regional outcome of the audit. However the findings have wider implications. For example the prevalence rate is more common in males than females. CBT is an important resource in the management of ADHD in adults. Priority and importance need to be given for providing a service for CBT in adults with ADHD.

Social implications

The cost of sickness and non-employment due to ADHD is significantly high. Treating this complex group with medications and CBT improves the outcome and get them back in employment and reduce recidivism rates in offenders.


The author feels the adult ADHD service audit has huge service implications. Currently it is a controversial diagnosis significantly under-resourced. The outcome survey had highlighted the areas of need as a neurodevelopmental disorder.



Declaration of interest: The author had presented and been a speaker at meetings sponsored and paid by Pharmaceutical Industries.


Febin Edwin, M. (2014), "Adult ADHD outcome audit based on NICE guidelines", Advances in Mental Health and Intellectual Disabilities, Vol. 8 No. 5, pp. 331-337.



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