Safe Prescribing in ADHD

Study Description and Methods

Attention deficit hyperactivity disorder (ADHD) is estimated to affect up to 5% of
adults. ADHD can significantly worsen the quality of life for those who suffer with the diagnosis. In addition, stimulant medications are among the most highly abused prescribed medications for adults with the diagnosis; however, pharmacological treatment has shown a positive impact on outcomes, long-term prognosis, and quality of life in adults with ADHD.

Although most primary care providers do not feel equipped to manage ADHD and prescribe stimulants to treat it, there have not been systematic investigations of stimulant medication prescribing errors. Approximately 70% of the medication errors in primary care are prescribing errors, thus this study will focus on a subset of medication error, the prescribing faults at the “prescriber” level.

Specific Aims and Objectives

The overall goal of this project is to optimize pharmacotherapy for patients with attention deficit hyperactivity disorder (ADHD) and promote safe and appropriate prescribing of stimulants and related medications in primary care.

The study has three related specific objectives:

Objective 1: To characterize stimulant and related medication prescribing patterns in primary care and concordance with prescribing recommendations to identify areas for improvement.

Objective 2: To study whether a practice-focused intervention that includes education, provider-level performance reports (using EHR data analytics) and audit and feedback improves provider competence and stimulant prescribing behavior and practice guideline concordance.

Objective 3: To explore feasibility of access to registry data from the Prescription Drug Monitoring Program (PDMP) and its potential use for practice quality improvement activities.
The results of the study will be utilized to address an important gap in knowledge
regarding issues associated with medication errors related to stimulant prescribing, use of existing regulatory structures, and clinical data to inform future research and quality improvement. This study has a potential to optimize safe and appropriate stimulant prescribing for adult patients with ADHD in primary care.

Timeline

This is a 24-month study that is scheduled to conclude in September of 2017.

Status

Phase 1 of the study consisted of a secondary data analysis of primary care physicians’ prescribing practices for ADHD. This phase included categorization of medication errors.

Phase 2 of the study is the practice-based intervention that includes six practices. This phase will include baseline assessment, delivery of the educational intervention, monitoring, and reassessment at the end of the study.

The results/findings will be disseminated after the study period is completed and the data has been analyzed.

Key Findings and Publications

Check back later for key findings and publications

Contact Information

For additional information about this study, please contact:

Melinda Coffman, MBA
Research Project Manager
AAFP National Research Network
1-800-274-2237 ext. 3177
melindac@aafp.org

Natalia Loskutova, MD, PhD
Principal Investigator
AAFP National Research Network
1-800-274-2237 ext. 3186
NLoskutova@aafp.org


This study is funded by grants from the Food and Drug Administration (FDA)