Comparative Effectiveness Research for Two Medical Home Models for Attention Deficit Hyperactivity Disorder

Boston Medical Center156 enrolled

Overview

The purpose of this study is to compare the effectiveness of two care models on ADHD outcomes: one, a model of basic care management and structured communication with specialists, consistent with conventional descriptions of a patient-centered Medical Home; and another, which combines the Medical Home with theory-based care management strategies to address common reasons for ADHD treatment failure.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

TRIPLE

Enrollment

156

Conditions

Attention Deficit/Hyperactivity Disorder

Interventions

Collaborative Care PlusBEHAVIORAL

Traditional collaborative care + systematic addressing of ADHD comorbidities, parental mental health issues, and adherence to treatment plans

Traditional Collaborative CareBEHAVIORAL

Traditional collaborative care, in which care managers serve as intermediaries between primary care physicians and specialists

Eligibility

Sex: ALLMin age: 6 YearsMax age: 12 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * Child is being evaluated for a potential diagnosis of ADHD by a primary care pediatrician at one of our sites. * Child is 6 to 12 years of age * Family plans to remain in the Boston area for the duration of the follow-up period * Mother is comfortable in English or Spanish Exclusion Criteria: * Child already has a confirmed diagnosis of ADHD * Child already receives ongoing specialty care in one or more of the following clinics: pediatric psychiatry, developmental behavioral pediatrics

Locations (1)

Boston Medical Center

Boston, Massachusetts, United States

Outcomes

Primary Outcomes

ADHD Symptoms

Swanson, Nolan and Pelham scale (SNAP-IV)

Time frame: 6 mo

ADHD Symptoms

Swanson, Nolan and Pelham scale (SNAP-IV)

Time frame: 12 mo

Patient Medication Adherence

Timely prescribed refills of ADHD medications - assessed through the EHR - will provide an accurate picture of medication adherence from the perspective of prescription writing. In addition, we will administer the validated Medication Adherence Scale, which has good reliability among parents of urban children with asthma

Time frame: 6 mo

Patient Medication Adherence

Time frame: 12 mo

Secondary Outcomes

ODD Symptoms

SNAP-IV

Time frame: 6 mo

Social Skills

Social Skills Rating System

Time frame: 6 mo

Time to Symptom Improvement

Based on follow-up ADHD symptom scales administered at regular intervals by our care managers, we will quantify the time between initial diagnosis and definitive improvement - conventionally defined by a 25% symptom reduction from baseline

Time frame: 12 mo

Data from ClinicalTrials.gov

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