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Implementing NICE Guidelines for ADHD: Key Strategies and Recommendations

This presentation focuses on the implementation of the NICE Clinical Guideline 72 on Attention Deficit Hyperactivity Disorder (ADHD), emphasizing important aspects for effective management and treatment. It covers the definition and symptoms of ADHD, along with diagnostic criteria and assessment. Key priorities include specialized training for healthcare professionals, parent education programs, and comprehensive treatment plans involving both drug and non-drug interventions. Practical recommendations are provided for engaging families and transitioning services, ensuring the needs of children and adults with ADHD are met.

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Implementing NICE Guidelines for ADHD: Key Strategies and Recommendations

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  1. Attention deficit hyperactivity disorder Implementing NICE guidance 2008 NICE clinical guideline 72

  2. Related guidance • This guideline incorporates recommendations from two technology appraisals: • Methylphenidate, atomoxetine and dexamfetamine for attention deficit hyperactivity disorder (ADHD) in children and adolescents. NICE technology appraisal guidance 98 • Parent-training/education programmes in the management of children with conduct disorders. NICE technology appraisal guidance 102

  3. What this presentation covers • Background • Key priorities for implementation • Costs • Discussion • Find out more

  4. Background: 1 • Definition of ADHD • - a heterogeneous behavioural syndrome with core symptoms of inattention, hyperactivity and impulsivity • Incidence of ADHD • Symptoms of ADHD

  5. Background: 2 • Diagnosis • Assessing severity

  6. Key priorities for implementation • Assessment and diagnosis of ADHD • Training and the role of specialist teams • Parent-training/education • Comprehensive treatment plans • Drug treatment

  7. Assessment and diagnosis • ADHD symptoms should: - meet diagnostic criteria in DSM-IV or ICD-10, and - be associated with at least moderate impairment in multiple settings, and - be pervasive, occurring in two or more settings • Diagnosis should include assessment of: - the person’s needs - coexisting disorders - social, family, educational/occupational circumstances - physical health For children and young people, assess parent or carer mental health

  8. Training and the role of specialist teams • Trusts should ensure that specialist ADHD teams develop age-appropriate training programmes • Teachers who have received training about ADHD should provide behavioural interventions in class

  9. Parent-training/education • Offer parents or carers of pre-school children referral to a parent-training/education programme as first-line treatment • Offer parents or carers of school-age children with moderate impairment referral to a group parent-training/education programme • A group treatment programme for school-age children (CBT and/or social skills training) may also be offered

  10. Comprehensive treatment plans: children and young people • Drug treatment for children and young people with ADHD should always form part of a comprehensive treatment plan that includes psychological, behavioural and educational advice and interventions • Develop transition service models according to best practice guidance

  11. Comprehensive treatment plans: adults • Drug treatment for adults with ADHD should always form part of a comprehensive treatment programme that addresses psychological, behavioural and educational or occupational needs

  12. Drug treatments: 1 • Pre-drug treatment assessment • Choice of drug treatment • Response to treatment • Licensing

  13. Drug treatments: 2

  14. Costs

  15. For discussion • What training is available locally for healthcare professionals who come into contact with a young person or adult with ADHD? • How do we involve young people or adults with ADHD and their parents/carers in making decisions about their care? • To what extent is current provision of parent/carer training programmes or group training programmes meeting local needs? • What is our local care pathway (for all ages) and how does this integrate with other organisations? • How do young people transfer to adult services in our area?

  16. Find out more • Visit www.nice.org.uk/cg072 for: • Other guideline formats • Costing report and template • Audit support • Implementation advice

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