Evidence-based or consensus-driven guidelines have become an important framework for consolidating practice across countries and helping to improve the quality of care.1-5
Clinical guidelines for the management of ADHD are intended to improve the process and outcomes of healthcare by:
- Providing evidence-based recommendations for the management of ADHD to help guide appropriate and rational choice of treatment1-5
- Assisting patients and their families or carers in making informed decisions about treatment options for ADHD1
- Improving communication between clinicians, patients and their families1
- Setting standards to assess the practice of healthcare professionals.1
There are several guidelines available to guide clinicians working in the field of ADHD in children, adolescents and adults, and different guidelines may also have different recommendations about specific treatment approaches.1-5 A systematic review of several guidelines identified greater levels of agreement on evidence-based pharmacological treatment than on psychosocial interventions, possibly reflecting the strength of evidence available to support each approach.6
The implementation of international, European and national guidelines at a local level of healthcare poses challenges, particularly given different healthcare systems, economic situations and cultural views. However, these guidelines may be of greater utility if they are used to inform local protocols adapted to reflect the local situation.6
Although guidelines are useful for clinicians, adherence to guideline recommendations will not ensure a successful outcome in every case.7 The ultimate judgement regarding the most appropriate clinical treatment for the individual patient with ADHD should be made by the responsible healthcare professional after discussing the options with the patient, parent/carer and/or partner.7
- NICE (2008) Attention Deficit Hyperactivity Disorder: Diagnosis and Management of ADHD in Children, Young People and Adults. NICE clinical guideline 72. Available at www.nice.org.uk/CG72 [NICE guideline]. Last accessed May 2015.
- Taylor E, Döpfner M, Sergeant J, et al. European clinical guidelines for hyperkinetic disorder – first upgrade. Eur Child Adolesc Psychiatry 2004; 13 (Suppl 1): I7-30.
- Kooij SJ, Bejerot S, Blackwell A, et al. European consensus statement on diagnosis and treatment of adult ADHD: The European Network Adult ADHD. BMC Psychiatry 2010; 10: 67.
- The Canadian Attention Deficit Hyperactivity Disorder Resource Alliance (CADDRA). Canadian ADHD Practice Guidelines (CAP-Guidelines) Third Edition. 2011. Available at: http://caddra.ca/practice-guidelines/download. Last accessed March 2015.
- Remschmidt H. Global consensus on ADHD/HKD. Eur Child Adolesc Psychiatry 2005; 14: 127-137.
- Seixas M, Weiss M, Müller U. Systematic review of national and international guidelines on attention-deficit hyperactivity disorder. J Psychopharmacol 2012; 26: 753-765.
- Scottish Intercollegiate Guidelines Network. Management of attention deficit and hyperkinetic disorders in children and young people: A national clinical guideline. Last updated October 2009. Last accessed March 2015.
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