Claire A MacGeorge1, Kathryn L King1, Annie N Simpson2, Erika L Abramson3, David G Bundy1, James T McElligott1. 1. Medical University of South Carolina, 135 Rutledge Avenue, MSC 561, Charleston, SC, 29425. 2. Medical University of South Carolina, 151-B Rutledge Avenue, MSC 962, Charleston, SC, 29425. 3. Weill Cornell Medical College, 525 East 68th Street, Room M610A, New York, NY, 10065.
Abstract
BACKGROUND: School-based health centers (SBHC) are in a unique position to provide guideline-driven attention-deficit/hyperactivity disorder (ADHD) care. In this study, we compared adherence to 2 components of ADHD guidelines in SBHC versus a continuity clinic. METHODS: We compared proportions of ADHD visits that had a structured symptom report available and timely follow-up in SBHC to a continuity clinic using chart review. We used multiple logistic regression to estimate the association between guideline adherence and clinic type. RESULTS: Participants who had a medication dose change were 3.9 times more likely (relative risk [RR] = 3.9, 95% confidence interval [CI] 3.0-5.1) to have a structured report present and 1.7 times more likely (RR = 1.7, 95% CI 1.2-2.2) to have follow-up within 30 days if they were seen in SBHC versus continuity clinic. Participants who were stable on their medication dose were 18 times more likely (RR = 18.0, 95% CI 11.3-29.0) to have a structured report present and 1.4 times more likely (RR = 1.4, 95% CI 1.3-1.6) to have follow-up within 100 days if they were seen in SBHC versus continuity clinic. CONCLUSIONS: Care provided in SBHC was associated with improved adherence to guidelines and has the potential to the improve pediatric ADHD outcomes.
BACKGROUND: School-based health centers (SBHC) are in a unique position to provide guideline-driven attention-deficit/hyperactivity disorder (ADHD) care. In this study, we compared adherence to 2 components of ADHD guidelines in SBHC versus a continuity clinic. METHODS: We compared proportions of ADHD visits that had a structured symptom report available and timely follow-up in SBHC to a continuity clinic using chart review. We used multiple logistic regression to estimate the association between guideline adherence and clinic type. RESULTS:Participants who had a medication dose change were 3.9 times more likely (relative risk [RR] = 3.9, 95% confidence interval [CI] 3.0-5.1) to have a structured report present and 1.7 times more likely (RR = 1.7, 95% CI 1.2-2.2) to have follow-up within 30 days if they were seen in SBHC versus continuity clinic. Participants who were stable on their medication dose were 18 times more likely (RR = 18.0, 95% CI 11.3-29.0) to have a structured report present and 1.4 times more likely (RR = 1.4, 95% CI 1.3-1.6) to have follow-up within 100 days if they were seen in SBHC versus continuity clinic. CONCLUSIONS: Care provided in SBHC was associated with improved adherence to guidelines and has the potential to the improve pediatric ADHD outcomes.
Authors: Emily E Johnson; Claire MacGeorge; Annie Andrews; Kathryn L King; Ronald J Teufel; Daniel L Brinton; Ryan Kruis; Kathryn C Hale; Dee Ford; Kathryn R Sterba Journal: Telemed J E Health Date: 2021-06-21 Impact factor: 5.033