Promoting Confidence and Evidence-Based Practices for Attention-Deficit/Hyperactivity Disorder among Integrated Primary Care Providers: A Qualitive Improvement Education Initiative

Introduction: Primary Care Providers (PCPs) are seeing growing number of patients presenting for adult attention-deficit/hyperactivity disorder (ADHD) evaluations as a result of social media influences highlighting ADHD. Yet, PCPs report lacking confidence and education with adult ADHD. The purpose of this quality improvement study was to develop educational materials to promote confidence, competence, and adherence to ADHD evidence-based recommendations among integrated care PCPs. Methods: A literature review and retrospective chart review of 19 patients were used to create 1) Baseline ADHD Provider Education (PE) tool, 2) Standardized ADHD Diagnosis (SAD) referral process, 3) ADHD Assessment, Treatment, and Monitoring (ATM) protocol, and 4) ADHD Treatment Monitoring (TM) recommendations for PCPs for the integrated care setting. Materials were presented to the PCPs followed by a 3-months follow-up post education chart review of (n=9) patients to determine consistency and adherence to protocol and monitoring recommendations. PCPs (n=7) were recruited to join this study and completed a pre- and post-intervention confidence and competency scale. Results: Although there was not a statistically significant difference in both the pre- and post-level of self-efficacy (U= 1.582, p = .138, r = .570) and level of confidence (U= 1.659, p = .101, r = .373), providers reported 30% improvement in self-efficacy and 80.1% improvement in confidence levels. Discussion: ADHD education can improve competence, confidence, and adherence among PCPs in ADHD management. Despite lacking universal adherence to all recommendations, there was an increase in utilization of these evidence-based practices, from pre to post, suggesting movement in the right direction.