Quality statement 6: Starting drug treatment

Quality statement

People with attention deficit hyperactivity disorder (ADHD) who are starting drug treatment have their initial drug dose adjusted and response assessed by an ADHD specialist.

Rationale

People starting drug treatment for ADHD should be closely monitored for side effects, particularly during the initial treatment period. Initial drug doses should be adjusted to ensure that any unwanted effects are minimised while optimising beneficial effects.

Quality measures

Structure

Evidence of local arrangements to ensure that people with ADHD who are starting drug treatment have their initial drug dose adjusted and response assessed by an ADHD specialist.

Data source: Local data collection.

Process

Proportion of people with ADHD who are starting drug treatment who have their initial drug dose adjusted and response assessed by an ADHD specialist.

Numerator – the number of people in the denominator who have their initial drug dose adjusted and response assessed by an ADHD specialist.

Denominator – the number of people with ADHD who are starting drug treatment.

Data source: Local data collection.

Outcome

Rates of drug-related side effects in people starting drug treatment for ADHD.

Data source: Local data collection.

What the quality statement means for service providers, health and social care practitioners, and commissioners

Service providers ensure that systems are in place for people with ADHD who are starting drug treatment to have their initial drug dose adjusted and response assessed by an ADHD specialist.

Healthcare practitioners ensure that people with ADHD who are starting drug treatment have their initial drug dose adjusted and response assessed by an ADHD specialist.

Commissioners ensure that they commission services for people with ADHD who are starting drug treatment to have their initial drug dose adjusted and response assessed by an ADHD specialist.

What the quality statement means for patients, service users and carers

People with ADHD who are starting medication have their initial medication dose adjusted by an ADHD specialist, who should also check how well the medication is working.

Definitions of terms used in this quality statement

ADHD specialist

A psychiatrist, paediatrician or other appropriately qualified healthcare professional with training and expertise in the diagnosis of ADHD.

[NICE's guideline on attention deficit hyperactivity disorder, recommendation 1.3.1]

Initial drug dose

Doses should be titrated against symptoms and adverse effects in line with the BNF or BNF for Children until dose optimisation is achieved, that is reduced symptoms, positive behaviour change, improvements in education, employment and relationships, with tolerable adverse effects.

[NICE's guideline on attention deficit hyperactivity disorder, recommendation 1.7.27]