This measure assesses the percentage of children newly prescribed attention-deficit/hyperactivity disorder (ADHD) medication who had at least three follow-up care visits within a 10-month period, one of which was within 30 days of when the first ADHD medication was dispensed. Two rates are reported:
- Initiation Phase. The percentage of members 6–12 years of age with a prescription dispensed for ADHD medication, who had one follow-up visit with a practitioner with prescribing authority during the 30-day Initiation Phase.
- Continuation and Maintenance (C&M) Phase. The percentage of members 6–12 years of age with a prescription dispensed for ADHD medication, who remained on the medication for at least 210 days and who, in addition to the visit in the Initiation Phase, had at least two follow-up visits with a practitioner within 270 days (9 months) after the Initiation Phase ended.
Why It Matters
ADHD is one of the more common chronic conditions of childhood. Children with ADHD may experience significant functional problems, such as school difficulties; academic underachievement; troublesome relationships with family members and peers; and behavioral problems.1Given the high prevalence of ADHD among U.S. children (8.7%, or 5.3 million individuals), primary care clinicians will regularly encounter children with ADHD and should have a strategy for diagnosing and long-term management of this condition.1,2
Medication may be recommended for ADHD treatment. The American Academy of Pediatrics (AAP) guidelines1 recommend that the prescribing clinician should titrate ADHD medication to achieve maximum benefit with tolerable side effects, and once symptom improvement is achieved, provide chronic care management with at least two visits annually. Organizations and providers have the ability to track medication use in patients and provide appropriate follow-up care to monitor clinical symptoms and potential adverse events. Additionally, organizations can foster programs and system changes that would help primary care practitioners and other providers ensure success in the ongoing care of patients with ADHD.
Historical Results – National Averages
Follow-Up Care for Children Prescribed ADHD Medication - Initiation Phase
| Measurement Year | Commercial HMO | Commercial PPO | Medicaid HMO |
|---|---|---|---|
| 2023 | 42.9 | 42.2 | 45 |
| 2022 | 43.3 | 40.4 | 43.6 |
| 2021 | 38.7 | 35.6 | 39.7 |
| 2020 | 42.1 | 40.0 | 43.9 |
| 2019 | 40.7 | 39.4 | 42.3 |
| 2018 | 40.6 | 39.6 | 44.2 |
| 2017 | 41.6 | 39.9 | 44.6 |
| 2016 | 40.0 | 39.0 | 44.5 |
| 2015 | 39.4 | 38.6 | 42.2 |
| 2014 | 38.2 | 36.7 | 40.1 |
| 2013 | 39.9 | 38.3 | 39.6 |
| 2012 | 38.6 | 38.1 | 39.0 |
| 2011 | 39.4 | 39.4 | 38.8 |
| 2010 | 38.8 | 38.1 | 38.1 |
| 2009 | 36.6 | 35.4 | 36.6 |
| 2008 | 35.8 | 34.1 | 34.4 |
| 2007 | 33.7 | 31.8 | 33.5 |
| 2006 | 33.0 | 30.6 | 31.8 |
Follow-Up Care for Children Prescribed ADHD Medication - Continuation and Maintenance Phase
| Measurement Year | Commercial HMO | Commercial PPO | Medicaid HMO |
|---|---|---|---|
| 2023 | 48.1 | 48.6 | 52.1 |
| 2022 | 48.5 | 46.7 | 53.1 |
| 2021 | 46.7 | 44.1 | 50 |
| 2020 | 48.8 | 47.4 | 53.5 |
| 2019 | 47.0 | 46.7 | 53.1 |
| 2018 | 49.7 | 46.8 | 54.6 |
| 2017 | 48.2 | 46.5 | 55.0 |
| 2016 | 46.5 | 45.8 | 54.5 |
| 2015 | 47.7 | 46.0 | 50.9 |
| 2014 | 46.5 | 43.5 | 47.5 |
| 2013 | 46.8 | 45.3 | 46.4 |
| 2012 | 45.7 | 44.9 | 45.3 |
| 2011 | 44.2 | 44.9 | 45.9 |
| 2010 | 43.4 | 43.3 | 43.9 |
| 2009 | 41.7 | 39.0 | 41.7 |
| 2008 | 40.2 | 37.1 | 39.5 |
| 2007 | 38.7 | 34.2 | 38.9 |
| 2006 | 38.1 | 30.0 | 34.0 |
This State of Healthcare Quality Report classifies health plans differently than NCQA’s Quality Compass. HMO corresponds to All LOBs (excluding PPO and EPO) within Quality Compass. PPO corresponds to PPO and EPO within Quality Compass.
Figures do not account for changes in the underlying measure that could break trending. Contact Information Products via my.ncqa.org for analysis that accounts for trend breaks.
References
- Woolrich, M.L., J.F. Hagan, Jr., C. Allan, E. Chan, D. Davison, M. Earls, S.W. Evans, S.K. Flinn, T. Froehlich, J. Frost, J.R. Holbrook, C.U. Lehmann, H.R. Lessin, K. Okechukwu, K.L. Pierce, J.D. Winner, W. Zurhellen. October 2019. “Subcommittee on Children and Adolescents With Attention-Deficit/Hyperactive Disorder. Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents.” Pediatrics 144(4):e20192528. Doi: 10.1542/peds.2019-2528. Erratum in: Pediatrics. 2020 Mar;145(3): PMID: 31570648; PMCID: PMC7067282.
- Bozinovic, K., F. McLamb, K. O’Connell et al. November 10, 2021. “U.S. National, Regional, and State-Specific Socioeconomic Factors Correlate with Child and Adolescent ADHD Diagnoses Pre-COVID-19 Pandemic.” Sci Rep 11(1):2. Doi: 10.1038/s41598-021-01233-2.
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