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2 Aug 2016

Young S et al. BMC Psychiatry 2016; 16: 301.

Despite the increased awareness of the importance of the transition of children with ADHD to adult clinical services, a streamlined, unified transition mechanism is still lacking across healthcare services in the UK. This article reports on the recommendations developed by a group of experts and patients assembled by the UK Adult ADHD Network in June 2012 to ensure a more effective transition of individuals with ADHD from child to adult health services without treatment interruption.

The panel encouraged the establishment of clear transition protocols, which should be devised co-operatively between referring and receiving services. These protocols should set a framework for the transition process, identify the responsibilities of the concerned individuals and agencies, and define clear criteria for referral and service provision. The consensus statement made the following general recommendations:

  • Clear transition protocols should be developed jointly with all services and agencies to facilitate transition and ensure that standards of care are maintained during the transition period
  • Protocols should outline timeframes, responsibilities and preparations for the patient, and what should happen if adult services are unable to accept the referral
  • The protocol should allow for flexibility in the age of transition, so as to accommodate developmental needs; however, transition should occur at a time of clinical stability
  • Psychoeducation should be provided with comprehensive, impartial and appropriately written information for both young people and their parents/carers
  • The needs and wishes of parents/carers should be respected, and their ongoing involvement with the young person negotiated
  • Where appropriate, allied professionals, e.g. probation services and those working in correctional units and prisons should be informed and educated
  • All healthcare services should be encouraged to use similar care pathways and outcome measures across different patient age groups.

Recommendations for future research were also made, and included: the reasons why patients stop taking medication and lose contact with their ADHD healthcare system during the transition period; pharmacological strategies to identify patients, before their transition to adult services, who are at risk of developing comorbid psychiatric difficulties; the effectiveness of non-pharmacological interventions; and the engagement of women with ADHD who are underrepresented in the research literature in the transition process.

Overall, the participants in this meeting concluded that the transition of children with ADHD to adult care remains vulnerable to poor planning and implementation. This warrants the instatement of protocols to regulate the transition process to maintain the standards of care and prevent drop-out from services. These protocols should remain flexible around the individual patient’s needs.

Read more about specific recommendations from UK Adult ADHD Network here

Young S, Adamou M, Asherson P, et al. Recommendations for the transition of patients with ADHD from child to adult healthcare services: a consensus statement from the UK adult ADHD network. BMC Psychiatry 2016; 16: 301.

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