559 - Caregiver and Referring Provider Satisfaction with Telehealth Management of Complex Attention-Deficit/Hyperactivity Disorder (ADHD)

Friday, April 28, 2023

5:15 PM – 7:15 PM ET

Poster Number: 559
Publication Number: 559.108

Silvia Pereira-Smith, Medical University of South Carolina College of Medicine, Charleston, SC, United States; Andrea D. Boan, Medical University of South Carolina College of Medicine, Charleston, SC, United States; Jessie Montezuma, Medical University of South Carolina College of Medicine, Charleston, SC, United States; Laura Carpenter, Medical University of South Carolina College of Medicine, Charleston, SC, United States

Presenting Author(s)

SP

Silvia Pereira-Smith, MD (she/her/hers)

Assistant Professor
Medical University of South Carolina College of Medicine
Charleston, South Carolina, United States

Background: Mental health conditions are on the rise, including ADHD. The medical home is appropriate for management of this common childhood disorder, yet primary care providers have expressed discomfort in caring for complex ADHD as defined by the 2020 Society for Developmental-Behavioral Pediatrics (SDBP) guidelines. Prior to the COVID-19 pandemic, telehealth was used sparingly as a viable option for increasing the reach of subspecialty services; subsequently, many healthcare providers changed practice operations by employing telehealth services, often for the first time, to include management of multifaceted conditions such as complex ADHD.

Objective: This pilot study aimed to gauge satisfaction of caregivers and referring providers of children with complex ADHD regarding telehealth Developmental-Behavioral Pediatrics (T-DBP) services, with an exploratory aim to assess if T-DBP services decreased caregiver distress specifically.

Design/Methods: This study included 20 caregiver participants (CPs) and 7 referring provider participants (RPPs) of 20 children ages 4-15 years with complex ADHD that were seen for a telehealth consultation plus 1-month follow-up at an affiliated satellite clinic. Participant sociodemographic information (Table 1) and post T-DBP satisfaction surveys were collected, plus baseline and post-T-DBP completion of Parental Stress Scale by CPs and skill-building questionnaires by RPPs.

Results: CPs reported high levels of overall satisfaction with T-DBP services (86%) and attention provided by T-DBP physician (93%), with 100% reporting decreased cost burden with T-DBP (Table 2). All RPPs reported high satisfaction for clarity of T-DBP medical-decision-making process and treatment plan provided; however, only 60% reported high satisfaction with timing of their patient’s T-DBP visit since referral and transition of complex ADHD management back to their setting. CPs reported a moderate level of parental stress with no significant improvements noted at follow-up (Table 3). RPPs reported lower levels of comfort in managing ADHD in children < 4 years and < 6 years of age in addition to prescribing ADHD medication in children age ≤ 5 years, with only moderate improvements noted post-consultation.

Conclusion(s):

T-DBP proved to be good model to help fill a treatment gap in rural communities for complex ADHD care, but with some caveats. For example, there is a need to increase education and comfort level of primary care providers to effectively transition complex ADHD care back to the medical home. Future directions for this study include enrolling a larger sample to assess true effects in CPs and RPPs.