- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT01143701
Evaluation of an Intervention for Improving Community-based Pediatric Attention-Deficit Hyperactivity Disorder (ADHD) Care
21. september 2016 opdateret af: Jeff Epstein, Children's Hospital Medical Center, Cincinnati
Evaluation of an Intervention for Improving Community-based Pediatric ADHD Care
ADHD is the most prevalent mental health disorder of childhood.
The majority of children with ADHD receive their care in primary care settings.
While the American Academy of Pediatrics (AAP) issued evidence-based guidelines and recommendations for pediatricians, most pediatricians have difficulty adhering to these guidelines.
Given observed deficiencies in evidence-based ADHD care and the likely effects on child outcomes, the development and testing of interventions aimed at improving ADHD care in primary care settings is necessary.
Cincinnati Children's Hospital Medical Center has developed a model intervention, termed the ADHD Collaborative, to comprehensively address this issue.
The ADHD Collaborative intervention model includes academic detailing, quality improvement methods, and innovative tools (e.g., web portal) designed to promote and support the systematic use of the AAP guidelines.
This intervention model has been used to train over 200 physicians at 55 practices in the Greater Cincinnati area.
The intervention appears to produce 2- to 4-fold increases in the use of evidence-based ADHD-related practice behaviors in participating physicians.
To date, the intervention has been implemented as a quality improvement project with few experimental controls.
The primary goal of the proposed study is to conduct an experimentally-controlled cluster randomized trial of the ADHD Collaborative intervention.
Thirty-two pediatric practices will be randomly assigned to receive the ADHD Collaborative intervention or to provide usual care.
Approximately 96 physicians and 576 of their ADHD patients will be included in the study.
Chart reviews, parental interviews, and parent and teacher rating scales will be collected.
Between- and within-group hierarchical linear modeling analyses will examine whether the intervention produces significant improvements in pediatrician practice behaviors, patient satisfaction with ADHD care, and child outcomes over and above typical ADHD care.
Also, the relative cost effectiveness of the ADHD Collaborative intervention over typical care will be established by computing incremental cost-effectiveness ratios using cost and effect size estimates.
Studieoversigt
Undersøgelsestype
Interventionel
Tilmelding (Faktiske)
577
Fase
- Fase 4
Kontakter og lokationer
Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.
Studiesteder
-
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Ohio
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Columbus, Ohio, Forenede Stater, 43205
- Nationwide Childrens Hospital
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Deltagelseskriterier
Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.
Berettigelseskriterier
Aldre berettiget til at studere
6 år til 11 år (Barn)
Tager imod sunde frivillige
Ingen
Køn, der er berettiget til at studere
Alle
Beskrivelse
Inclusion Criteria:
- Practice must have a minimum of two pediatricians who agree to participate.
- Practice must have an electronic billing system.
- Practice must have internet access at office.
- Practice must not have an on-site mental health professional.
- Practice must have a member of practice staff willing to be trained in human subjects certification and willing to consent families.
- Children must be in Grade 1-5.
- Children must be newly diagnosed with ADHD.
Exclusion Criteria:
-
Studieplan
Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Sundhedstjenesteforskning
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Enkelt
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
---|---|
Eksperimentel: ADHD Collaborative Intervention
The ADHD Collaborative intervention model includes academic detailing, quality improvement methods, and innovative tools (e.g., web portal) designed to promote and support the systematic use of the American Academy of Pediatrics consensus recommendation for evidence-based ADHD care.
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The ADHD Collaborative intervention model includes academic detailing, quality improvement methods, and innovative tools (e.g., web portal) designed to promote and support the systematic use of the AAP guidelines.
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Ingen indgriben: Typical ADHD care
Physicians in this group will provide typical ADHD care.
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
---|---|---|
Parent-rated ADHD Symptoms
Tidsramme: 12 months
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Total Symptom Score on Parent-Rated Vanderbilt ADHD Rating Scale (range=0-54).
Higher scores represent more severe ADHD symptom presentation.
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12 months
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Teacher-rated ADHD Symptoms
Tidsramme: 12 months
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Total Symptom Score on Teacher-Rated Vanderbilt ADHD Rating Scale (range=0-54).
Higher scores represent more severe ADHD symptom presentation.
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12 months
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Samarbejdspartnere og efterforskere
Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.
Publikationer og nyttige links
Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.
Generelle publikationer
- Gordon MK, Baum RA, Gardner W, Kelleher KJ, Langberg JM, Brinkman WB, Epstein JN. Comparison of Performance on ADHD Quality of Care Indicators: Practitioner Self-Report Versus Chart Review. J Atten Disord. 2020 Aug;24(10):1457-1461. doi: 10.1177/1087054715624227. Epub 2016 Jan 28.
- Brinkman WB, Baum R, Kelleher KJ, Peugh J, Gardner W, Lichtenstein P, Langberg J, Epstein JN. Relationship Between Attention-Deficit/Hyperactivity Disorder Care and Medication Continuity. J Am Acad Child Adolesc Psychiatry. 2016 Apr;55(4):289-94. doi: 10.1016/j.jaac.2016.02.001. Epub 2016 Feb 5.
- Epstein JN, Kelleher KJ, Baum R, Brinkman WB, Peugh J, Gardner W, Lichtenstein P, Langberg J. Variability in ADHD care in community-based pediatrics. Pediatrics. 2014 Dec;134(6):1136-43. doi: 10.1542/peds.2014-1500. Epub 2014 Nov 3.
- Epstein JN, Langberg JM, Lichtenstein PK, Kolb R, Simon JO. The myADHDportal.com Improvement Program: An innovative quality improvement intervention for improving the quality of ADHD care among community-based pediatricians. Clin Pract Pediatr Psychol. 2013 Mar 1;1(1):55-67. doi: 10.1037/cpp0000004.
- Epstein JN, Kelleher KJ, Baum R, Brinkman WB, Peugh J, Gardner W, Lichtenstein P, Langberg JM. Impact of a Web-Portal Intervention on Community ADHD Care and Outcomes. Pediatrics. 2016 Aug;138(2):e20154240. doi: 10.1542/peds.2015-4240.
Datoer for undersøgelser
Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.
Studer store datoer
Studiestart
1. maj 2010
Primær færdiggørelse (Faktiske)
1. maj 2015
Studieafslutning (Faktiske)
1. juni 2016
Datoer for studieregistrering
Først indsendt
11. juni 2010
Først indsendt, der opfyldte QC-kriterier
11. juni 2010
Først opslået (Skøn)
14. juni 2010
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
8. november 2016
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
21. september 2016
Sidst verificeret
1. september 2016
Mere information
Begreber relateret til denne undersøgelse
Andre undersøgelses-id-numre
- MH083665
- 1R01MH083665-01A2 (U.S. NIH-bevilling/kontrakt)
Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .
Kliniske forsøg med ADHD
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InnosphereIkke rekrutterer endnu
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The Hong Kong Polytechnic UniversityRekruttering
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VIZO Specs LtdRekruttering
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University of North Carolina, Chapel HillNational Institute of Mental Health (NIMH)Rekruttering
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Florida State UniversityRekruttering
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Florida International UniversityRekruttering
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Region Örebro CountyRekruttering
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Johns Hopkins UniversityTrukket tilbage
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Tris Pharma, Inc.Premier Research Group plcAfsluttet
Kliniske forsøg med ADHD Collaborative
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The University of Hong KongRekruttering
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Children's Hospital Medical Center, CincinnatiAfsluttet
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Indiana UniversityAgency for Healthcare Research and Quality (AHRQ)AfsluttetAttention Deficit Hyperactivity DisorderForenede Stater
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Göteborg UniversityAfsluttetAttention Deficit Disorder med hyperaktivitetSverige
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Lumos Labs, Inc.Rekruttering
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Universitaire Ziekenhuizen KU LeuvenKU Leuven; Research Foundation FlandersAktiv, ikke rekrutterende
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Lumos Labs, Inc.AfsluttetADHDForenede Stater
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University of BergenThe Research Council of NorwayAfsluttet