New ADHD prescribing guide launches

It is hoped a new guide for healthcare professionals will equip GPs with the most comprehensive and up-to-date information about prescribing medications for attention-deficit/hyperactivity disorder (ADHD).
 
This week, the ADHD Professionals Association (AADPA) launched its ‘ADHD Prescribing Guide for Australian Healthcare Professionals‘, a document designed to be a practical tool for GPs to consult.
 
The guide covers a range of topics, including diagnosis, assessment, medication choice, dosing, monitoring, adverse effects, switching, stopping, and specific populations.
 
It follows the release of AADPA’s ‘Clinical Practice Guideline for ADHD‘ in 2022.
 
Lead author and AADPA President Professor David Coghill said the guide’s release comes after experts found ‘significant variability’ in ADHD prescribing across Australia.
 
‘It delivers clear and consistent information on the pharmacological treatment of ADHD across different age groups and settings,’ he said.
 
‘It’s an extraordinary resource that is intended to complement, not replace, the clinical judgement and expertise of healthcare professionals who prescribe or manage ADHD medications.’

The guide recommends the ‘most successful approach to managing ADHD’ comes from a mix of different strategies including psychoeducation, cognitive therapy, and ADHD coaching.
 
It goes on to provide guidance on when ADHD medications should be considered and who should prescribe them, medication available for children or those with coexisting mental health conditions, and how to monitorprogress.
 
Chair of RACGP Specific Interests ADHD, ASD and Neurodiversity Associate Professor John Kramer descried the new prescribing guide as a ‘logical extension’ to previous ADHD guidelines.
 
‘It’s important to stress, whenever you’re talking about ADHD, that management is always multimodal, in other words, you’re doing a number of different things,’ he told newsGP.
 
‘Medication is one of the most effective tools when people are significantly impaired in various ways, but it’s always got to be combined with education.
 
‘You’ve got to educate the child, the parents, how they can live with it somewhat better, lifestyle change, cognitive behavioural therapy, counselling in general – those sorts of things are all important and combining these with medication can make a huge difference.’
 
In Australia, ADHD is the most common neurodevelopmental disorder in children and adolescents, impacting between 6% and 10% of young people, as well as up to 6% of adults.
 
In recent years, increased awareness of the disorder has led to spikes in diagnosis and prescriptions, with a Senate investigation into ADHD finding that in 2018, 186,423 Australians were written 1.36 million prescriptions, but by 2022, the number of patients being treated rose to 413,747.
 
A newsGP poll carried out last year found 95% of respondents said they had noticed an increase in patients requesting referrals for an ADHD diagnosis in the past year.
 
The RACGP has long been calling for GPs to be enabled to play a greater part in addressing rising ADHD presentations, as well as consistent rules across all states and territories on which clinicians can diagnose and prescribe stimulant medications for patients.
 
Associate Professor Kramer said one of the most important things GPs can take away from the prescribing guidelines is to think about the entire patient journey, not just individual appointments.
 
‘It’s also important to remember the positive stuff about ADHD, that’s something that I’ve learned to bring up with parents of kids, and now routinely, once I’ve made the diagnosis, ask the parents, and the kid if they’re old enough, to give me a list of their strengths as well as their struggles,’ he said.
 
‘When you identify somebody who’s struggling and bring in the various interventions, you can get some really good results, it’s very, very satisfying.
 
‘Particularly when you’re dealing with children, if you can see a kid in kindergarten who’s on the brink of suspension and expulsion and you come in and intervene, you’re potentially allowing society to have 60 years of productive input from that individual.’
 
Moving forward, the AADPA said the new guide was designed to be a ‘living document’ and will be updated to reflect any changes in the future.
 
The ‘ADHD Prescribing Guide for Australian Healthcare Professionals’ is now available to order, either in print or as an eBook, from the AADPA website.
 
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