Follow-up care of children identified with ADHD by primary care clinicians: A prospective cohort study

J Pediatr. 2004 Dec;145(6):767-71. doi: 10.1016/j.jpeds.2004.08.028.


Objective: To document follow-up care received by children identified with attention deficit hyperactivity disorder (ADHD) by primary care clinicians (PCCs).

Study design: We surveyed families of children 4 to 15 years of age who had been diagnosed with ADHD. At an index office visit, parents and clinicians completed questionnaires. Six months after the index visit, parents completed a questionnaire (N = 659 returned surveys, 68% return rate). The main outcome measure was the number of visits with the patients' PCCs or mental health specialists during the 6 months after the index visit.

Results: Children had a median of one visit PCC over a period of 6 months. Children who had prescriptions for psychotropic medications (78%) did not differ from others in the number of visits. Follow-up visits with the child's own doctor were more common when the PCC had completed mental health training. Only 26% of patients saw a mental health specialist. Children who were black, on Medicaid, or with higher levels of internalizing symptoms were more likely to see a mental health specialist.

Conclusions: Children treated for ADHD need more follow-up visits to permit adjustment of medication and support continuation of patients in treatment. Systematic quality improvement efforts are warranted.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Attention Deficit Disorder with Hyperactivity / diagnosis
  • Attention Deficit Disorder with Hyperactivity / drug therapy
  • Attention Deficit Disorder with Hyperactivity / therapy*
  • Behavior Therapy*
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Mental Health Services / statistics & numerical data
  • Primary Health Care / statistics & numerical data*
  • Prospective Studies
  • Randomized Controlled Trials as Topic
  • Treatment Outcome