Examining the pharmacological and psychological treatment of child and adolescent ADHD in Australia: Protocol for a retrospective cohort study using linked national registry data

Daniel P Sullivan; Leanne Payne; Kelsie A Boulton; Natalie Silove; Mark A Bellgrove; Emma Sciberras; David R Coghill; Adam J Guastella; Christel M Middeldorp

doi:10.1136/bmjopen-2022-064920

Examining the pharmacological and psychological treatment of child and adolescent ADHD in Australia: Protocol for a retrospective cohort study using linked national registry data

BMJ Open. 2022 Nov 23;12(11):e064920. doi: 10.1136/bmjopen-2022-064920.

Authors

Daniel P Sullivan^{1

2}, Leanne Payne^{1

2}, Kelsie A Boulton^{3

4}, Natalie Silove⁵, Mark A Bellgrove⁶, Emma Sciberras^{7

8}, David R Coghill^{9

10}, Adam J Guastella^{4

11}, Christel M Middeldorp^{12

2}

Affiliations

¹ Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia.
² Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Service, South Brisbane, Queensland, Australia.
³ Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia.
⁴ Clinic for Autism and Neurodevelopmental (CAN) Research, The University of Sydney, Sydney, New South Wales, Australia.
⁵ Child Development Unit, The Sydney Children's Hospitals Network Randwick and Westmead, Westmead, New South Wales, Australia.
⁶ Turner Institute for Brain and Mental Health, School of Psychological Science, Monash University, Clayton, Victoria, Australia.
⁷ School of Psychology, Deakin University, Burwood, Victoria, Australia.
⁸ Deakin University Centre for Social and Early Emotional Development, Burwood, Victoria, Australia.
⁹ Departments of Paediatrics and Psychiatry, University of Melbourne, Melbourne, Victoria, Australia.
¹⁰ The Royal Children's Hospital Melbourne, Parkville, Victoria, Australia.
¹¹ Clinical Research Unit, Brain and Mind Research Institute, Camperdown, New South Wales, Australia.
¹² Child Health Research Centre, The University of Queensland, South Brisbane, Queensland, Australia c.middeldorp@uq.edu.au.

Abstract

Introduction: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder which affects 5% of children globally. In Australia, it is estimated that 4.1% of children and adolescents have ADHD. While research has examined the treatment and outcomes of children with ADHD attending public mental health services during their time in the public system in Australia, it is not known what treatment they received before and after these treatment episodes, which will provide a more complete understanding of these children's treatment journey.

Methods and analysis: We will link clinical data from cohorts of children and adolescents treated in the public child and youth mental health and/or child development services in Brisbane, Melbourne and Sydney to the Medicare Benefits Schedule (MBS), Pharmaceutical Benefits Scheme (PBS) and National Death Index. MBS data will demonstrate the treatment journey with respect to clinicians seen, and treatment episodes from the public health service data sets will be examined to assess if the type and intensity of treatment are related to treatment outcomes. PBS data will reveal all psychotropic medications prescribed, allowing an examination of not just ADHD medications, but also other psychotropics which may indicate co-occurring conditions (eg, anxiety and mood disorders). Statistical analyses will include descriptive statistics to describe the rates of specific medications and clinician specialties seen. Linear and logistic regression will be used to model how treatment and sociodemographic variables relate to routinely collected outcome measures in the public health system while controlling for covarying factors.

Ethics and dissemination: This study has been approved by the following institutional ethics committees: (1) Children's Health Queensland Hospital and Health Service (HREC/21/QCHQ/76260), (2) The University of Queensland (2021/HE002143) and (3) The Australian Institute of Health and Welfare (EO2021/4/1300). Findings will be disseminated through peer-reviewed journals, conferences, professional associations and to public mental health services that treat ADHD.

Keywords: Child & adolescent psychiatry; Impulse control disorders; PAEDIATRICS.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Aged
Attention Deficit Disorder with Hyperactivity* / diagnosis
Attention Deficit Disorder with Hyperactivity* / drug therapy
Australia
Child
Humans
Medicare
Psychotropic Drugs / therapeutic use
Registries
Retrospective Studies

Substances

Psychotropic Drugs