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ADHD Study Ties mHealth Use to Clinical Improvements

Physicians using a digital health platform to treat children with ADHD and connect with caregivers saw a reduction in symptoms through better medication management.

- Community pediatric practices who use mHealth technology to treat children with ADHD are seeing clinical improvements, according to a new study.

The study, detailed in the online journal Pediatrics, finds that doctors can use online tools to measure a child’s responsiveness to ADHD medication and adjust the care plan when treatment isn’t working. It also enables clinicians to work more closely and more often with those children and their families and teachers.

"Our data show the software not only helped improve the quality of medication care received by children treated at community based pediatric practices, but it also improved treatment outcomes for these children," Jeffrey Epstein, PhD, director of the Center for ADHD at Cincinnati Children's Hospital Medical Center and the study’s principal investigator, said in a press release. "As a result of the improved quality of ADHD care, children treated by pediatricians using this new technology had significantly less ADHD symptoms than children treated by pediatricians who were not given access to this web-based technology." 

The ADHD care quality improvement (QI) software, developed at Cincinnati Children’s and licensed to IXICO Technologies, is now being used by the American Academy of Pediatrics in a five-state project to help pediatric practices improve care for children with ADHD.

For its study, Cincinnati Children’s partnered with Nationwide Children’s Hospital in Columbus, Ohio, to test the software in 50 community pediatric practices involving more than 200 providers. Some 373 children were involved in the test, with some receiving technology-enhanced care and the rest receiving traditional care.

Through the platform, clinicians can access reports filed online by parents and teachers on each child’s ADHD symptoms. The clinician can measure symptoms against the child’s medication protocols, and adjust treatment if needed.

According to Epstein and Kelly Kelleher, MD, director of Nationwide Children’s Hospital’s Center for Innovation in Pediatric Practice, children treated with the technology-enhanced care plan saw a larger decrease in symptoms than did children receiving traditional care. In addition, those treated with the QI program “had significantly more treatment contacts with clinical staff and a greater number of parent and teacher ratings to monitor the effectiveness of medications.”

In addition, the researchers said “treatment effectiveness and outcomes were more quickly assessed at practices using the software.”

The study offers proof that clinicians in busy community practices, who often deal with underserved populations with limited access to healthcare, can use mHealth platforms to improve care coordination, including medication management.

The platform used by Cincinnati Children’s was originally developed in 2013 with the help of Duke University and UK-based Optimal Medicine. Originally called mehealth for ADHD, the technology has been used by Phil Lichtenstein, MD, a Cincinnati Children’s pediatrician and co-researcher in the study.

With roughly 11 percent of the nation’s school-aged children diagnosed with ADHD or similar behavioral disorders, according to the Centers for Disease Control and Prevention, doctors are looking to mHealth to fill in the gaps between office visits, especially when such a visit might not occur for several months. In an interview last year, Lichtenstein noted ADHD medications can be adjusted every three to seven days, so it's important to monitor children almost every day to see if any changes in medication are needed and, when instituted, whether they work.

"In the old world, working with paper, it would be impossible to get this turn-around time," he said, and the child and his/her caregivers would suffer as a result. "In actuality, with something like this, you can make decisions without needing a face-to-face visit, and can actually manage treatment several times in between office visits."

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