The management of ADHD in children and adolescents: bringing evidence to the clinic: perspective from the European ADHD Guidelines Group (EAGG)
Year: 2021
Type: review
Abstract: ADHD is the most common neurodevelopmental disorder presenting to child and adolescent mental health, paediatric, and primary care services. Timely and effective interventions to address core ADHD symptoms and co-occurring problems are a high priority for healthcare and society more widely. While much research has reported on the benefits and adverse effects of different interventions for ADHD, these individual research reports and the reviews, meta-analyses and guidelines summarizing their findings are sometimes inconsistent and difficult to interpret. We have summarized the current evidence and identified several methodological issues and gaps in the current evidence that we believe are important for clinicians to consider when evaluating the evidence and making treatment decisions. These include understanding potential impact of bias such as inadequate blinding and selection bias on study outcomes; the relative lack of high-quality data comparing different treatments and assessing long-term effectiveness, adverse effects and safety for both pharmacological and non-pharmacological treatments; and the problems associated with observational studies, including those based on large national registries and comparing treatments with each other. We highlight key similarities across current international clinical guidelines and discuss the reasons for divergence where these occur. We discuss the integration of these different perspective into a framework for person/family-centered evidence-based practice approach to care that aims to achieve optimal outcomes that prioritize individual strengths and impairments, as well as the personal treatment targets of children and their families. Finally, we consider how access to care for this common and impairing disorder can be improved in different healthcare systems.
Authors: David Coghill, Tobias Banaschewski, Samuele Cortese, Philip Asherson, Daniel Brandeis, Jan Buitelaar, David Daley, Marina Danckaerts, Ralf W. Dittmann, Manfred Doepfner, Maite Ferrin, Chris Hollis, Martin Holtmann, Santosh Paramala, Edmund Sonuga-Barke, César Soutullo, Hans-Christoph Steinhausen, Saskia Van der Oord, Ian C K Wong, Alessandro Zuddas, Emily Simonoff
Institutions: Royal Children's Hospital, The University of Melbourne, Murdoch Children's Research Institute, Heidelberg University, Central Institute of Mental Health, University of Nottingham, Solent NHS Trust, NYU Langone Health, Institute of Mental Health, NIHR MindTech MedTech Co-operative, University of Southampton, New York University, King's College London, University of Zurich, ETH Zurich, Psychiatrische Universitätsklinik Zürich, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, KU Leuven, Medizinische Fakultät Mannheim, University of Cologne, University Hospital Cologne, LWL-Universitätsklinik Hamm, Ruhr University Bochum, South London and Maudsley NHS Foundation Trust, NIHR Maudsley Biomedical Research Centre, University of Southern Denmark, University of Basel, Aarhus University, Mental Health Services, University Hospital Zurich, University of Amsterdam, UCL School of Pharmacy, University College London, University of Cagliari, Azienda Ospedaliera G. Brotzu
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,760
Funders: Eli Lilly and Company, Sunovion, National Institute for Health and Care Excellence, National Institute for Health and Care Research, University of Cambridge, University of Oxford, Deutsche Forschungsgemeinschaft, Volkswagen Foundation, Bundesministerium für Bildung und Forschung, Bundesministerium für Gesundheit, Servier, H. Lundbeck A/S, National Institute of Mental Health, Cilag
OpenAlex ID: W3207759740