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What do general practitioners know about ADHD? Attitudes and knowledge among first-contact gatekeepers: systematic narrative review

Tatlow-Golden, Mimi; Prihodova, Lucia; Gavin, Blanaid; Cullen, Walter and McNicholas, Fiona (2016). What do general practitioners know about ADHD? Attitudes and knowledge among first-contact gatekeepers: systematic narrative review. BMC Family Practice, 17(1), article no. 129.

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DOI (Digital Object Identifier) Link: https://doi.org/10.1186/s12875-016-0516-x
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Abstract

Background: Attention Deficit Hyperactivity Disorder (ADHD) is a common childhood disorder with international prevalence estimates of 5 % in childhood, yet significant evidence exists that far fewer children receive ADHD services. In many countries, ADHD is assessed and diagnosed in specialist mental health or neuro-developmental paediatric clinics, to which referral by General (Family) Practitioners (GPs) is required. In such ‘gatekeeper’ settings, where GPs act as a filter to diagnosis and treatment, GPs may either not recognise potential ADHD cases, or may be reluctant to refer. This study systematically reviews the literature regarding GPs’ views of ADHD in such settings.
Methods: A search of nine major databases was conducted, with wide search parameters; 3776 records were initially retrieved. Studies were included if they were from settings where GPs are typically gatekeepers to ADHD services; if they addressed GPs’ ADHD attitudes and knowledge; if methods were clearly described; and if results for GPs were reported separately from those of other health professionals.
Results: Few studies specifically addressed GP attitudes to ADHD. Only 11 papers (10 studies), spanning 2000–2010, met inclusion criteria, predominantly from the UK, Europe and Australia. As studies varied methodologically, findings are reported as a thematic narrative, under the following themes: Recognition rate; ADHD controversy (medicalisation, stigma, labelling); Causes of ADHD; GPs and ADHD diagnosis; GPs and ADHD treatment; GP ADHD training and sources of information; and Age, sex differences in knowledge and attitudes.
Conclusions: Across times and settings, GPs practising in first-contact gatekeeper settings had mixed and often unhelpful attitudes regarding the validity of ADHD as a construct, the role of medication and how parenting contributed to presentation. A paucity of training was identified, alongside a reluctance of GPs to become involved in shared care practice. If access to services is to be improved for possible ADHD cases, there needs to be a focused and collaborative approach to training.

Item Type: Journal Item
Copyright Holders: 2016 The Authors
ISSN: 1471-2296
Project Funding Details:
Funded Project NameProject IDFunding Body
Newman Fellowship (UCD)Not SetShire
Keywords: Attention-deficit hyperactivity disorder; ADHD; General practice; Family practice; Gatekeepers; Attitudes; Systematic review; Training
Academic Unit/School: Faculty of Wellbeing, Education and Language Studies (WELS) > Education, Childhood, Youth and Sport > Childhood, Youth and Sport > Childhood and Youth
Faculty of Wellbeing, Education and Language Studies (WELS) > Education, Childhood, Youth and Sport > Childhood, Youth and Sport
Faculty of Wellbeing, Education and Language Studies (WELS) > Education, Childhood, Youth and Sport
Faculty of Wellbeing, Education and Language Studies (WELS)
Research Group: Childhood Youth and Sport Group (CYSG)
Item ID: 55654
Depositing User: Mimi Tatlow-Golden
Date Deposited: 02 Jul 2018 10:46
Last Modified: 02 May 2019 18:05
URI: http://oro.open.ac.uk/id/eprint/55654
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