Comparison of Attention-Deficit/Hyperactivity Disorder Care Between School-Based Health Centers and a Continuity Clinic

J Sch Health. 2019 Dec;89(12):953-958. doi: 10.1111/josh.12836. Epub 2019 Oct 14.

Abstract

Background: School-based health centers (SBHC) are in a unique position to provide guideline-driven attention-deficit/hyperactivity disorder (ADHD) care. In this study, we compared adherence to 2 components of ADHD guidelines in SBHC versus a continuity clinic.

Methods: We compared proportions of ADHD visits that had a structured symptom report available and timely follow-up in SBHC to a continuity clinic using chart review. We used multiple logistic regression to estimate the association between guideline adherence and clinic type.

Results: Participants who had a medication dose change were 3.9 times more likely (relative risk [RR] = 3.9, 95% confidence interval [CI] 3.0-5.1) to have a structured report present and 1.7 times more likely (RR = 1.7, 95% CI 1.2-2.2) to have follow-up within 30 days if they were seen in SBHC versus continuity clinic. Participants who were stable on their medication dose were 18 times more likely (RR = 18.0, 95% CI 11.3-29.0) to have a structured report present and 1.4 times more likely (RR = 1.4, 95% CI 1.3-1.6) to have follow-up within 100 days if they were seen in SBHC versus continuity clinic.

Conclusions: Care provided in SBHC was associated with improved adherence to guidelines and has the potential to the improve pediatric ADHD outcomes.

Keywords: health service applications; mental health; school-based clinics.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Child
  • Community Health Services*
  • Female
  • Guideline Adherence
  • Humans
  • Logistic Models
  • Male
  • Medical Audit
  • Multivariate Analysis
  • School Health Services*