Evaluation of an Intervention for Improving Community-based Pediatric Attention-Deficit Hyperactivity Disorder (ADHD) Care
2016年9月21日 更新者: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.
研究概览
研究类型
介入性
注册 (实际的)
577
阶段
- 第四阶段
联系人和位置
本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。
学习地点
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Ohio
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Columbus、Ohio、美国、43205
- Nationwide Childrens Hospital
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参与标准
研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
6年 至 11年 (孩子)
接受健康志愿者
不
有资格学习的性别
全部
描述
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:
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学习计划
本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。
研究是如何设计的?
设计细节
- 主要用途:卫生服务研究
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:单身的
武器和干预
参与者组/臂 |
干预/治疗 |
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实验性的: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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无干预:Typical ADHD care
Physicians in this group will provide typical ADHD care.
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
---|---|---|
Parent-rated ADHD Symptoms
大体时间: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
大体时间: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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合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
一般刊物
- 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.
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始
2010年5月1日
初级完成 (实际的)
2015年5月1日
研究完成 (实际的)
2016年6月1日
研究注册日期
首次提交
2010年6月11日
首先提交符合 QC 标准的
2010年6月11日
首次发布 (估计)
2010年6月14日
研究记录更新
最后更新发布 (估计)
2016年11月8日
上次提交的符合 QC 标准的更新
2016年9月21日
最后验证
2016年9月1日
更多信息
与本研究相关的术语
其他研究编号
- MH083665
- 1R01MH083665-01A2 (美国 NIH 拨款/合同)
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.
多动症的临床试验
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University Hospital, Strasbourg, France招聘中
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Centre for Anxiety, Attention Deficit and Trauma...Shire完全的
ADHD Collaborative的临床试验
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Tjhin WigunaDr Cipto Mangunkusumo General Hospital; Fakultas Kedokteran Universitas Indonesia; Binus University...未知
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Children's Hospital Medical Center, CincinnatiNational Institute of Mental Health (NIMH)完全的
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Ann & Robert H Lurie Children's Hospital of Chicago招聘中