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Young people with attention deficit hyperactivity disorder in transition from child to adult services: A qualitative study of the experiences of general practitioners in the UK

BMC Family Practice Nov 28, 2019

Newlove-Delgado T, et al. - Given that impairing symptoms persisting into adulthood are seen in many young individuals with Attention Deficit Hyperactivity Disorder (ADHD), yet the continuity of care into adult life is experienced by only a minority, and although there is increasing stress on the primary care role in ADHD management in National Institute for Health and Care Excellence (NICE) ADHD and transition guidance, little is understood regarding General Practitioners (GPs)’ viewpoints, which could hinder attempts to better results for young individuals leaving children’s services. Therefore, researchers interrogated GPs across the UK in order to gain insights into their experiences of involvement with this group as well as to know their perspectives on the roles and duties of primary and secondary care in transition, to inform recommendations for policy and practice. The involvement of many GPs ‘by default’ was reported in the absence of a smooth transition from child to adult services. GPs responded by attempting to recognize suitable specialist services and encountered the decision of whether to continue ADHD prescribing. A strong impact on such decisions was exerted by views that prescribing carried risks, and concerns over responsibility, especially where specialist services were lacking. Findings revealed a highly variable implementation of NICE guidance, with implications for GPs and patients. The central concerns identified in this study, that are required to be addressed, were risk and responsibility for primary care ADHD prescribing and the incorporation of GPs in a planned transition process.
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