Brooke S G Molina1, Heidi L Kipp2, Heather M Joseph2, Stacey A Engster3, Seth C Harty4, Montaya Dawkins2, Rachel A Lindstrom2, Daniel J Bauer5, Srihari S Bangalore6. 1. Department of Psychiatry (BSG Molina, HL Kipp, HM Joseph, SC Harty, M Dawkins, RA Lindstorm, and SS Bangalore), University of Pittsburgh School of Medicine and University of Pittsburgh Medical Center, Pittsburgh, Pa; Department of Psychology (BSG Molina), University of Pittsburgh, Pittsburgh, Pa; Department of Pediatrics (BSG Molina and SA Engster), University of Pittsburgh School of Medicine, Pittsburgh, Pa. Electronic address: molinab@upmc.edu. 2. Department of Psychiatry (BSG Molina, HL Kipp, HM Joseph, SC Harty, M Dawkins, RA Lindstorm, and SS Bangalore), University of Pittsburgh School of Medicine and University of Pittsburgh Medical Center, Pittsburgh, Pa. 3. Department of Pediatrics (BSG Molina and SA Engster), University of Pittsburgh School of Medicine, Pittsburgh, Pa. 4. Department of Psychiatry (BSG Molina, HL Kipp, HM Joseph, SC Harty, M Dawkins, RA Lindstorm, and SS Bangalore), University of Pittsburgh School of Medicine and University of Pittsburgh Medical Center, Pittsburgh, Pa; Department of Psychology (SC Harty), University of Canterbury, Christchurch, New Zealand. 5. Department of Psychology and Neuroscience (DJ Bauer), University of North Carolina, Chapel Hill, NC. 6. Department of Psychiatry (BSG Molina, HL Kipp, HM Joseph, SC Harty, M Dawkins, RA Lindstorm, and SS Bangalore), University of Pittsburgh School of Medicine and University of Pittsburgh Medical Center, Pittsburgh, Pa; Department of Psychiatry (SS Bangalore), Kaiser Permanente, Roseville Medical Center, Roseville, Calif.
Abstract
OBJECTIVE: To address increasing rates of stimulant misuse in college students, this study developed an evidence-based, brief clinical practice intervention for primary care providers (PCPs) to reduce stimulant medication diversion among young adults with attention-deficit/hyperactivity disorder (ADHD). METHODS: College students (N-114; 18-25 years; 68% attending universities; 24% attending community college) treated for ADHD with a stimulant and their PCPs across six practices participated in this initial, uncontrolled study of pre- to post-intervention change. An educational workshop providing strategies aimed at reducing stimulant diversion was developed and delivered to providers and staff across all practices (50% pediatric; 50% family medicine). Patients and providers completed baseline and post intervention surveys. RESULTS: Diversion was relatively infrequent, 16.7% at baseline and 14.9% post-intervention, respectively. Statistically significant decreases from baseline to post-intervention were found for three diversion risk factors: (1) number of times approached to divert, (2) intent to share, sell, or trade stimulants, and (3) disclosure of stimulant use. Providers and staff reported mostly high satisfaction with the training. CONCLUSIONS: This study provides initial evidence for a PCP-delivered intervention to reduce stimulant diversion. Research is needed on the efficacy of targeting college students directly, working with pharmacies and student health centers, and preventing misuse among teenagers.
OBJECTIVE: To address increasing rates of stimulant misuse in college students, this study developed an evidence-based, brief clinical practice intervention for primary care providers (PCPs) to reduce stimulant medication diversion among young adults with attention-deficit/hyperactivity disorder (ADHD). METHODS: College students (N-114; 18-25 years; 68% attending universities; 24% attending community college) treated for ADHD with a stimulant and their PCPs across six practices participated in this initial, uncontrolled study of pre- to post-intervention change. An educational workshop providing strategies aimed at reducing stimulant diversion was developed and delivered to providers and staff across all practices (50% pediatric; 50% family medicine). Patients and providers completed baseline and post intervention surveys. RESULTS: Diversion was relatively infrequent, 16.7% at baseline and 14.9% post-intervention, respectively. Statistically significant decreases from baseline to post-intervention were found for three diversion risk factors: (1) number of times approached to divert, (2) intent to share, sell, or trade stimulants, and (3) disclosure of stimulant use. Providers and staff reported mostly high satisfaction with the training. CONCLUSIONS: This study provides initial evidence for aPCP-delivered intervention to reduce stimulant diversion. Research is needed on the efficacy of targeting college students directly, working with pharmacies and student health centers, and preventing misuse among teenagers.
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