Thursday, July 19, 2007

Improving Treatment and Educating Key Audiences

New Treatment Guidelines Announced
The latest issue of a professional journal contains an article with new assessment and treatment guidelines for childhood AD/HD. Information on these guidelines is available on the Web sites for CHADD (see “In The News”) and our National Resource Center on AD/HD (see “Latest News”). These are two separate announcements on the same topic.

Individuals with AD/HD and their families look to their doctors and other health care professionals to accurately diagnose and suggest effective plans of treatment. CHADD, a national consumer and family membership organization with 14,000 members, applauds the American Academy of Child and Adolescent Psychiatry (AACAP) for publishing its revised Practice Parameter for AD/HD.

CHADD completely agrees with the conclusion in the Journal of the American Academy of Child and Adolescent Psychiatry (July 2007 issue, page 916): “The key to effective long-term management of the patient with AD/HD is continuity of care with a clinician experienced in the treatment of AD/HD.” CHADD will continue to work to ensure that all families and professionals are familiar with and practice the latest in evidence-based medicine.

In 2002, the National Initiative for Children’s Healthcare Quality (NICHQ) launched its community collaborative demonstration to enhance pediatric practices for diagnosing and treating AD/HD in 30 communities. NICHQ included a variety of partners, including CHADD and the American Academy of Pediatrics (AAP). NICHQ based its community collaborative using three theories of change—will (leaders who desire to enhance clinical practice), ideas (AAP guidelines provided evidence-based new ideas), and execution (change in health care delivery requires additional infrastructure and incentives).

In many of the community collaborative sites, primary care physicians increased their use of the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV), increased use of teacher-provided information, increased use of written plans of care, increased structured diagnostic assessments in the patient chart, and improved levels of functioning by patients. NICHQ’s efforts paralleled the AAP eQIPP initiative (education for Quality Improvement in Pediatric Practices). Increased collaboration between pediatric practices and schools increased in a few communities.

Among the reasons that some community collaborative projects failed to meet initial expectations were lack of local leadership and commitment by pediatricians, families, teachers, and schools; inertia or the unwillingness to actually change clinical practice, including enhanced roles for office-based nurses; withdrawal of technical supports such as academic medical center backup to private practices; failure of health care payers to financially reward improved clinical practices; and the reality of difficulty in truly engaging with others to build collaborative teams.

We need more community collaborative projects to truly enhance the use of science-based guidelines. CHADD advocates for better family access to professionals practicing the latest evidence-based guidelines.

Educating Federal Legislators
On November 8, all CHADD annual conference attendees will visit with their U.S. Congressional delegations as an integral part of the conference. This is CHADD’s first effort to have such a number of people meet with legislators. “Morning on the Hill” is our November 8 conference event; there are no other conference events that morning. Everyone will be on “The Hill.” We are making the appointments, conducting the training, and providing the transportation and support.

In a little over a week, 34 chapter and national leaders have already volunteered to serve as “captains,” moderators and facilitators for the appointments. Captains will be supported by CHADD staff, sister organizations that specialize in such events, and our national volunteer leaders. To have over a thousand people on the Hill, we will need 100-200 captains.

We are organizing these appointments with members of Congress because:
(1) Our strategic objective is to further our building of a social movement to support persons with AD/HD and related disorders and enhance public education about AD/HD.
(2) Our tactical objective is to demonstrate to the United States Congress that we are an important and numerous constituency focused on a legitimate and frequently serious disorder.

Please register for the conference now, and in early September we will begin making appointments. Join other conference attendees to inform members of Congress what living with AD/HD is all about. Speak from your personal experience!


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