Quality standard
Quality statement 6: Starting drug treatment
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
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
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.
What the quality statement means for different audiences
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.
Health and social care 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.
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.
Source guidance
Attention deficit hyperactivity disorder: diagnosis and management. NICE guideline NG87 (2018, updated 2019), recommendations 1.7.2, 1.7.26 and 1.7.27
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]