Senate delays release of ADHD report

A parliamentary committee tasked with investigating the barriers facing attention deficit hyperactivity disorder (ADHD) patients has pushed back the release of its long-awaited final report.
 
The ‘Assessment and support services for people with ADHD’ Senate Inquiry has spent the past seven months collating 700 submissions, alongside three public hearings.
 
Its final report was due to be handed down on Wednesday, but that date has now been pushed back to 6 November to allow more time for it to be completed.
 
The delay comes as new freedom of information (FOI) documents, released by the Department of Health and Aged Care, revealed that in 2018, 186,423 Australians were written 1.36 million prescriptions for ADHD, but by 2022, the number of patients being treated had skyrocketed to 413,747.
 
Over the same period, government expenditure also rose from $59 million to $152 million.
 
Associate Professor John Kramer, Chair of RACGP Specific Interests ADHD, Autism Spectrum Disorder (ASD) and Neurodiversity told newsGP he believes the rise can be, in part, attributed to lisdexamfetamine’s addition to the PBS in February 2021.
 
‘The two main factors are increased diagnosis and treatment, and introduction of an additional stimulant to the PBS,’ he said.
 
According to the FOI documents, methylphenidate was the most prescribed ADHD medicine in 2022 with more than 1.2 million prescriptions dispensed, with most going to males.
 
The second most prescribed medication was lisdexamfetamine (sold as Vyvanse), despite the Therapeutic Goods Administration (TGA) reporting of a shortage of the drug due to manufacturing issues.
 
Shortages of the 30 mg capsules are expected to last until the end of 2023.
 
Associate Professor Kramer also believes the COVID-19 pandemic played a part in the expansion of diagnoses.
 
‘The lockdowns in the cities, and especially Melbourne, which was more effective than anywhere else, made life more difficult for everybody,’ he said.
 
‘But one of the ways ADHD individuals manage, before they diagnosed, is exercise and that becomes a lot harder when you’re locked down and your normal structures are lost, so I think that played a part.’
 
In a newsGP poll carried out in March this year, 95% of respondents said they had noticed an increase in patients requesting referrals for an ADHD diagnosis in the past year.
 
In its submission to the inquiry, released earlier this year, the RACGP said GPs need to play a greater part in addressing rising ADHD presentations across Australia, including acting as care coordinators.
 
It said care for patients is currently ‘inadequate’, with people continuing to face significant barriers to accessing treatments.
 
Associate Professor Kramer agrees, saying GPs are already experts in managing chronic conditions.
 
‘We do it all the time. We manage people’s diabetes, their asthma, their blood pressure, their arthritis, all those things, and we only refer those patients who are particularly complicated or who aren’t responding to the usual things that we do,’ he said.
 
‘ADHD is a classic chronic condition and it’s often not too hard to manage once you’ve got the diagnosis, so not everybody needs to go and see a specialist.’
 
His advice for GPs helping patients with ADHD is to take a good family history, and follow-up with a longer consultation to discuss treatment options.
 
‘It’s becoming quite common for when a child is diagnosed, a parent will often start to wonder if they’ve got it too because ADHD is absolutely inherited,’ he said.
 
‘So with an ADHD child, the next question might be which parent gave it to them? And usually, it’s pretty clear, and sometimes it’s both.
 
‘It’s important to validate the concern and say, “come back, we’ll make another time”, and that should be a good half-hour appointment. That’s our bread and butter as GPs.’
 
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ADHD Senate inquiry