The ground-breaking new Australian ADHD Guideline has set the benchmark for diagnosis and treatment.
The new Australian Evidence-Based Clinical Practice Guideline for ADHD, developed by the Australian ADHD Professionals Association (AADPA), is the most up to date set of protocols for the assessment, diagnosis, and treatment of ADHD in the world.
The fully searchable and downloadable Guideline went live at 12.01am on October the 5th, 2022, at https://adhdguideline.aadpa.com.au/, with the launch timed to coincide with the Light WA event that saw major landmarks in Perth lit bright orange to celebrate ADHD Awareness Month.
This is the first time the National Health and Medical Research Council (NHMRC) has approved an ADHD Clinical Practice Guideline which has also been endorsed by every major association, college, and consumer group in the country.
AADPA President, Professor Mark Bellgrove said that this landmark document was the result of a remarkable collaboration of clinicians, researchers, and people living with ADHD, over the past two years.
“The way the professional and lived-experience communities have come together to develop these Guidelines is a watershed moment,” Professor Bellgrove said.
“We want to make sure that front line clinicians have as much credible and evidence-based information as possible, and a huge amount of work has gone into making sure that the Guideline can be adapted and used in multiple clinical settings including GPs, paediatricians, psychiatrists, psychologists, and allied health.
“The Guideline will result in better clinical care for people with ADHD, it will help reduce stigma, and stop harmful disinformation.”
The Guideline also covers families and individuals, and will be important for educators, the workplace, and other areas like the justice system.
“There’s an individual living with ADHD at the centre but there’s a whole network of family, friends, teachers and employers that need guidance and support too,” Professor Bellgrove explained.
ADHD is the most common neurodevelopmental condition in children and adolescents but can often be diagnosed for the first time in adulthood and a full evaluation of the social and economic costs of the condition, conducted on behalf of AADPA by Deloitte Access Economics estimated that ADHD costs Australia nearly $20.42 billion per year, or $25,071 per person affected.
The Guideline’s 111 clinical recommendations cover a person’s ADHD journey across their lifespan from identification and diagnosis through to an evolving support plan and information for the many people who play a supporting role.
Funded by a Federal Government grant, recommendations were made by systematically reviewing the research evidence with certainty and strength of recommendations noted.
Where research evidence was not found or did not meet the guideline standard, clinical consensus recommendations and clinical practice points were made based on the expertise of the multidisciplinary guideline development group.
The recommendations include:
- Clinicians being aware that some people have a higher risk of having ADHD, including those who have a close relative with ADHD, people with neurodevelopmental and mental health conditions.
- A thorough assessment is needed to make a diagnosis of ADHD including a comprehensive clinical interview and use of rating scales and ensuring the symptoms are present in multiple settings.
- Upon diagnosis, information and support should be provided to the person, their parents/carers, including explanation of available treatment options and information about how they can minimise symptoms and maximise their strengths.
- Non-medication interventions can improve broader aspects of functioning for people with ADHD and/or their families.
- Parent/family training should be offered to parents/carers of children and adolescents with ADHD to support the family.
- Cognitive-behavioural interventions should be offered to adolescents and adults with ADHD.
- Medication interventions can improve the core symptoms of ADHD
- Clinicians and people with ADHD (or their parents/carers) should make treatment decisions together. Choice and dosage of medication must be optimised for each person.
- Ongoing monitoring is required to assess whether the medication is effective, and whether there are any unwanted effects.
- As a child with ADHD grows up, their clinicians should plan for a smooth move from health services for children to health services for adolescents, and later to adult health services.
Professor Bellgrove said that the Guideline had also highlighted several knowledge gaps that need to be addressed urgently.
“There are a few areas, but one that stands out, is the huge gap in our knowledge base about how ADHD presents in girls and women – if we can detect girls with ADHD better in childhood, we have a real opportunity to change and improve lives,” he said.
Other areas include national prescribing standards, better care pathways and involving GPs more in the diagnosis and treatment of people with ADHD.
“There’s still a lot of work to be done but we’ve already started, and we know the next steps we need to take,” Professor Bellgrove concluded.