Awareness of ADHD in primary care: stakeholder perspectives

French, B.; Perez Vallejos, E.; Sayal, K.; Daley, D.

Abstract

© 2020 The Author(s). Background: Attention Deficit Hyperactivity Disorder (ADHD) is underdiagnosed in many European countries and the process of accessing care and diagnosis is complex and variable. In many countries, general practitioners (GPs) refer on to secondary care where individuals receive an assessment and, if appropriate, a diagnosis and access to care. It is therefore essential that GPs have a clear understanding of the disorder and its care pathways. While previous studies have highlighted potential barriers in GPs' ADHD awareness, this qualitative study aims to further explore individual stakeholders' experiences. Methods: Semi-structured interviews explored the views of multiple stakeholders- GPs (n = 5), healthcare specialists (n = 5), patients (adults with ADHD n = 5) and parents (n = 5) with experience of the presentation and management of ADHD in primary care. These interviews were analysed using thematic analyses and following principles of grounded theory. Results: Stakeholders described ADHD assessment, diagnosis and treatment as an intricate process. Many factors affected this process such as complex pathways, lack of services, limited GP recognition and knowledge, and communicative difficulties between and within multiple stakeholders. Conclusion: This analysis underlines the significant impact that receiving (or not) a diagnosis can have, and further explores muddled ADHD care pathways, highlighting key issues around GP identification and the shortage of adult services. Implications for practice and future research are discussed, suggesting a strong need for more commissioned pathways and GP specific educational programs.

Citation

French, B., Perez Vallejos, E., Sayal, K., & Daley, D. (2020). Awareness of ADHD in primary care: stakeholder perspectives. BMC Family Practice, 21(1), Article 45. https://doi.org/10.1186/s12875-020-01112-1

• Journal Article Type: Review
• Acceptance Date: Feb 16, 2020
• Online Publication Date: Feb 28, 2020
• Publication Date: Feb 28, 2020
• Deposit Date: Feb 21, 2020
• Publicly Available Date: Feb 28, 2020
• Journal: BMC Family Practice
• Electronic ISSN: 1471-2296
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 21
• Issue: 1
• Article Number: 45
• DOI: https://doi.org/10.1186/s12875-020-01112-1
• Keywords: ADHD, Interviews, Primary care, Pathway to care
• Public URL: https://nottingham-repository.worktribe.com/output/4005323
• Publisher URL: https://link.springer.com/article/10.1186/s12875-020-01112-1
• Additional Information: Received: 24 July 2019; Accepted: 17 February 2020; First Online: 28 February 2020; : The study was approved by the University of Nottingham Faculty of Medicine Research Ethic Committee and the Nottinghamshire Healthcare NHS Foundation Trust R&D department. After the participants were made familiar with the interview process, written consent was obtained.; : Not applicable.; : Prof. Daley reports grants, personal fees and non-financial support from Shire, personal fees and non-financial support from Medice, personal fees and non-financial support from Eli Lilly, non-financial support from QbTech, outside the submitted work. Mrs. French reports personal fees and non-financial support from Shire. Prof. Sayal and Dr. Perez Vallejos report no conflicts of interest.