Recruiting

ADHD Care Manager

Sponsor:

Weill Medical College of Cornell University

Code:

NCT00644566

Conditions

ADHD

Eligibility Criteria

Sex: All

Age: 6 - 17

Healthy Volunteers: Not accepted

Interventions

Shared Care

Study Details

Brief summary:

Due to the shortage of child psychiatrists and the high prevalence of child mental health disorder, pediatricians and other pediatric primary care providers often assume responsibility for the management of various psychiatric disorders, including ADHD, Attention Deficit Hyperactivity Disorder. However, pediatricians have not been well-trained during residency to deal with the complexities of ADHD management. In addition, the system of care under which pediatricians practice do not afford the time availability that is required to properly manage a child with ADHD. On the other hand, if a pediatrician wishes to refer a patient to a child mental health specialist, many obstacles, including but not limited to stigma, insurance issues, and long waiting lists, often interfere with the patient actually receiving services for his/her ADHD. This research project seeks to examine an innovative model of care in which a child psychologist is located on the premises of a pediatric office and is available to share the care of patients with the pediatrician in order to address ADHD. We hypothesize that parents as well as pediatricians will be more satisfied with this model of care and that patients will ultimately have better outcomes. The beginning of our pilot has shown under-identification to be a barrier to care as well, and thus we propose to implement a quality improvement initiative to screen children for psychosocial issues as well. As we have had trouble with recruitment and unfortunately have had more children randomized to TAU than shared care, we propose in December 2007 a phase 2 of our study where all subjects, instead of randomization, are entered into shared care.

Conditions

ADHD

Study ID

NCT00644566

Start date

Aug, 2006

Status verified date

Nov, 2010

Completion date

Jun, 2008

Anticipated

Primary completion date

Jun, 2008

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 6 - 17

Healthy Volunteers: Not accepted

Inclusion Criteria (Patient subjects):

  • Age 6-17
  • Suspected diagnosis of ADHD, inattentive type, hyperactive type, combined type, NOS
  • Living with Guardian for at least 6 months
  • English-speaking child
  • English-speaking guardian
  • Telephone Access to Guardian
  • Inclusion for Randomization or Phase 2 shared care:
  • Diagnosis of ADHD

Exclusion Criteria:

  • Mental Retardation
  • Co-morbid psychotic disorder
  • Suicidal
  • Homicidal
  • Dangerous behavior
  • Foster care
  • Impairing co-morbid psychiatric disorder that would make ADHD treatment in a pediatric clinic unsafe or inappropriate (in the judgment of the PI based on the case review of the findings of the clinical psychologist.)
  • Allergic or contraindication to stimulant medications

Inclusion Criteria (Provider subjects):

  • Provider at Cornell Campus Helmsley Tower 5/ Long Island City Campus

Exclusion Criteria:

  • None

Inclusion for screening:

  • Age 6-17
  • Child is to be seen by pediatric provider at HT5
  • Parent or guardian reads English or Spanish

Exclusion Criteria:

  • Parent/Guardian has received screen within the year
  • Patient is too sick for parent to spend time on form

Study Design

Enrollment

140 participants

Anticipated

Allocation

Randomized

Intervention Model

Parallel Assignment

Primary purpose

Health Services Research

Interventions and Outcome Measures

Arms

no intervention: TAU

Treatment as usual. These subjects and their providers were told to pursue treatment services as they normally would do.

experimental: shared care

A psychologist co-located in the pediatric primary care clinic shared care with the subject's pediatrician. The psychologist offered regular appointments and psychoeducation. On an individual basis, parent management training, behavioral management training, individual psychotherapy, educational intervention assistance, teacher communication, and medication education were provided as needed.

Interventions

Shared Care

A psychologist co-located in the pediatric primary care clinic shared care with the subject's pediatrician. The psychologist offered regular appointments and psychoeducation. On an individual basis, parent management training, behavioral management training, individual psychotherapy, educational intervention assistance, teacher communication, and medication education were provided as needed.

Primary outcome measure

  • A higher proportion of patients treated by the pediatric providers and psychologists than those in usual care receive doses of medication that are consistent with AAP (American Academy of Pediatrics) recommendations [ Time Frame: six months ]

Central Contacts and Locations

Central contacts

Rachel A Zuckerbrot, MD

212-543-2628zuckerbr@childpsych.columbia.edu

Locations

New York Presbyterina Hospital- Weill Cornell Medcial College HT5 Pediatrics Clinic

Recruiting

New York, New York, United States, 10021

More Information

Sponsor

Weill Medical College of Cornell University

Last update posted

Nov 5, 2010

Last verified

Nov, 2010

Keywords

  • ADHD
  • Primary Care
  • Pediatrics
  • Health services
  • shared care
  • care manager
  • screening

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-10. This information was provided to ClinicalTrials.gov by Weill Medical College of Cornell University on 2010-11-05.