Federal Government backs ADHD prescribing consistency

The Federal Government has given its full support to the development of uniform and nationally consistent attention deficit hyperactivity disorder (ADHD) prescribing rules.
 
The backing comes as part of its response to a Senate inquiry into ADHD assessment and treatment barriers, which was handed down more than one year ago.
 
Of the 15 recommendations made by the Senate Committee, national consistency was the only one to receive the Federal Government’s full support, with nine others ‘supported in principle’ and the remaining five ‘noted’.
 
As part of its response, it also acknowledges the ‘broad reaching recommendations’ put forward and ‘the difficulties Australians with ADHD are experiencing in navigating a fragmented system’.
 
‘It is also recognised that there are opposing views about the best way to address these issues,’ its response states.
 
The RACGP has been advocating for some time to increase the role that GPs play in the management of ADHD, with many of the college’s representatives contributing directly to the inquiry.
 
The Government’s commitment to the development of ‘uniform prescribing rules to ensure consistency between state and territory jurisdictions’, will be handled by the Ministerial Council on Health.
 
Chair of RACGP Specific Interests Child and Young Person’s Health Dr Tim Jones, who has a special interest in neurodevelopmental paediatrics, told newsGP this move will make things a lot easier in a system that can be ‘an absolute nightmare’.
 
‘It’s very confusing for families to navigate when they’re already juggling a lot if they have a child with neurodiversity,’ he said.
 
‘We do need a uniform structure that supports every state and territory delivering a very similar set of safety rules around these medications.’
 
Another course of action put forward, which was ‘supported in principle’, was to expand the range of how GPs can provide ADHD assessment and support services.
 
The Federal Government notes that current policy ‘may enable potentially unnecessary restrictions on scope, such as PBS rules which currently restrict GPs from prescribing for conditions such as ADHD’.
 
This is a promising move forward, says Dr Jones.
 
‘I would love to see a process where a GP with adequate training can receive appropriate credentialing recognised by the Government and the relevant authorities to say that they are entirely capable of providing long-term assessment, support and pharmacology for children with ADHD,’ he said.
 
However, the ‘noted’ recommendation 13, which addressed the proposal for an Australian evidence-based clinical practice guideline for ADHD for healthcare professionals, includes wording that raises concerns with Dr Jones.
 
‘GPs already receive training and education in ADHD as part of their studies, however, GPs may pursue further mental health training,’ it reads.
 
Dr Jones said it is ‘concerning to keep talking about this like it’s a mental health condition’.
 
‘The impacts on a child’s mental health can be very significant but at the core of what we’re talking about is neurodiversity,’ he said.
 
‘Talking about how GPs can receive mental health training is missing the point around this, as this is actually about developmental medicine, it’s about ensuring that children who are differing from typical development receive everything they need to thrive and have a good, long-term future.
 
‘And no one is better placed to assess how a child is going than a GP.’
 
Earlier this year the ADHD Professionals Association released a new guideline designed to be a practical tool for GPs in diagnosis, assessment, medication choice, dosing, monitoring, adverse effects, switching, stopping, and specific populations.
 
Lead author and AADPA President Professor David Coghill said at the time of the guide’s release that experts had found ‘significant variability’ in ADHD prescribing across Australia.
 
Overall, Dr Jones thinks it’s ‘fantastic to see the Government paying attention’ but it is collaboration that is key.
 
‘We don’t have enough resources to fix the current access challenge, especially if everyone’s just trying to fix it in their silos,’ he said.
 
‘We need to see collaboration with our paediatric services, with our schools, with our family support organisations and the NDIS to really make sure that everyone is doing the best they can in their scope and that everyone is also pulling in the same direction.’
 
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ADHD attention deficit hyperactivity disorder children’s health prescribing Senate