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Sponsors and Collaborators: |
Weill Medical College of Cornell University National Institute of Mental Health (NIMH) New York State Psychiatric Institute Research Foundation for Mental Hygiene Columbia University |
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Information provided by: | Weill Medical College of Cornell University |
ClinicalTrials.gov Identifier: | NCT00644566 |
Due to the shortage of child psychiatrists and the high prevalence of child mental health disorder, pediatricians and other pediatric primary care providers often assume responsibility for the management of various psychiatric disorders, including ADHD, Attention Deficit Hyperactivity Disorder.
However, pediatricians have not been well-trained during residency to deal with the complexities of ADHD management. In addition, the system of care under which pediatricians practice do not afford the time availability that is required to properly manage a child with ADHD. On the other hand, if a pediatrician wishes to refer a patient to a child mental health specialist, many obstacles, including but not limited to stigma, insurance issues, and long waiting lists, often interfere with the patient actually receiving services for his/her ADHD. This research project seeks to examine an innovative model of care in which a child psychologist is located on the premises of a pediatric office and is available to share the care of patients with the pediatrician in order to address ADHD. We hypothesize that parents as well as pediatricians will be more satisfied with this model of care and that patients will ultimately have better outcomes. The beginning of our pilot has shown under-identification to be a barrier to care as well, and thus we propose to implement a quality improvement initiative to screen children for psychosocial issues as well. As we have had trouble with recruitment and unfortunately have had more children randomized to TAU than shared care, we propose in December 2007 a phase 2 of our study where all subjects, instead of randomization, are entered into shared care.
Condition | Intervention |
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ADHD |
Other: Shared Care |
Study Type: | Interventional |
Study Design: | Health Services Research, Randomized, Open Label, Parallel Assignment |
Official Title: | Pilot Study of Shared Care of ADHD in a Pediatric Clinic:Colocation of a Psychologist as an ADHD Care Manager |
Estimated Enrollment: | 140 |
Study Start Date: | August 2006 |
Estimated Study Completion Date: | June 2008 |
Estimated Primary Completion Date: | June 2008 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
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TAU: No Intervention
Treatment as usual. These subjects and their providers were told to pursue treatment services as they normally would do.
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shared care: Experimental
A psychologist co-located in the pediatric primary care clinic shared care with the subject's pediatrician. The psychologist offered regular appointments and psychoeducation. On an individual basis, parent management training, behavioral management training, individual psychotherapy, educational intervention assistance, teacher communication, and medication education were provided as needed.
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Other: Shared Care
A psychologist co-located in the pediatric primary care clinic shared care with the subject's pediatrician. The psychologist offered regular appointments and psychoeducation. On an individual basis, parent management training, behavioral management training, individual psychotherapy, educational intervention assistance, teacher communication, and medication education were provided as needed.
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Study Goals:
A. To compare patients with ADHD (Attention Deficit Hyperactivity Disorder) treated by a pediatric provider in collaboration with a co-located psychologist/ADHD care manager available for evaluation/assessment and ongoing shared-care consultation to patients with ADHD in a pediatric primary care clinic treated as usual.
Patients treated by the pediatricians with the added co-located services will have clinical outcomes that are superior to those that receive usual care
B. Pediatricians' morale and attitudes to the treatment of ADHD will improve with the addition of a co-located psychologist.
C. ADDITIONAL AIMS:
D. Operationalize Shared Care by examining what happens in such an arrangement, and see if patient recruitment and provider buy-in improves when shared care is assured.
Ages Eligible for Study: | 6 Years to 17 Years |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria (Patient subjects):
Exclusion Criteria:
Inclusion Criteria (Provider subjects):
Exclusion Criteria:
Inclusion for screening:
Exclusion Criteria:
Contact: Rachel A Zuckerbrot, MD | 212-543-2628 | zuckerbr@childpsych.columbia.edu |
United States, New York | |
New York Presbyterina Hospital- Weill Cornell Medcial College HT5 Pediatrics Clinic | Recruiting |
New York, New York, United States, 10021 | |
Long Island City Community Practice | Active, not recruiting |
Long Island City, New York, United States, 11106 |
Principal Investigator: | Daniel Hyman, MD | New York Presbyterian Hospital |
Principal Investigator: | Rachel Zuckerbrot, MD | Columbia University/New York State Psychiatric Institute |
Principal Investigator: | Mark Olfson, MD | Columbia University/New York State Psychiatric Institute |
Responsible Party: | New York Presbyterian Hospital ( Daniel Hyman, M.D., M.M.M. ) |
Study ID Numbers: | 0604008460 |
Study First Received: | March 19, 2008 |
Last Updated: | March 25, 2008 |
ClinicalTrials.gov Identifier: | NCT00644566 History of Changes |
Health Authority: | United States: Institutional Review Board |
ADHD Primary Care Pediatrics Health services |
shared care care manager screening |