Evaluation of a Web-Based ADHD Awareness Training in Primary Care: Pilot Randomized Controlled Trial With Nested Interviews

Overview

Journal JMIR Med Educ

Publisher JMIR Publications

Specialties Biotechnology
General Medicine
Medical Education

Date 2020 Dec 11

PMID 33306027

Citations 4

Authors

Blandine French

Charlotte Hall

Elvira Perez Vallejos

Kapil Sayal

David Daley

Affiliations

Soon will be listed here.

Abstract

Background: Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder affecting up to 5% of children and adults. Undiagnosed and untreated ADHD can result in adverse long-term health, educational, and social impacts for affected individuals. Therefore, it is important to identify this disorder as early as possible. General practitioners (GPs) frequently play a gatekeeper role in access to specialist services in charge of diagnosis and treatment. Studies have shown that their lack of knowledge and understanding about ADHD can create barriers to care.

Objective: This pilot randomized controlled trial assesses the efficacy of a web-based psychoeducation program on ADHD tailored for GPs.

Methods: A total of 221 participants were randomized to either a sham intervention control or an awareness training intervention and they completed questionnaires on ADHD knowledge, confidence, and attitude at 3 time points (preintervention, postintervention, and 2-week follow-up). Participants in the intervention arm were invited to participate in a survey and follow-up interview between 3 and 6 months after the intervention.

Results: The responses of 109 GPs were included in the analysis. The knowledge (P<.001) and confidence (P<.001) of the GPs increased after the intervention, whereas misconceptions decreased (P=.04); this was maintained at the 2-week follow-up (knowledge, P<.001; confidence, P<.001; misconceptions, P=.03). Interviews and surveys also confirmed a change in practice over time.

Conclusions: These findings demonstrate that a short web-based intervention can increase GPs' understanding, attitude, and practice toward ADHD, potentially improving patients' access to care.

Trial Registration: International Standard Randomized Controlled Trial Number ISRCTN45400501; http://www.isrctn.com/ISRCTN45400501.

Citing Articles

Effectiveness and cost-effectiveness of interventions to increase knowledge and awareness of attention deficit hyperactivity disorder: a systematic review.

McKenna K, Dona S, Gold L, Silk T, Le H Eur Child Adolesc Psychiatry. 2025; .

PMID: 39864035 DOI: 10.1007/s00787-025-02646-4.

Barriers and facilitators to implementing a Canadian shared-care ADHD program in pediatric settings in Shanghai: a consolidated framework for implementation research approach.

Bahraini S, Maisonneuve A, Wu D, Huang M, Xu M, Yang L BMC Health Serv Res. 2024; 24(1):564.

PMID: 38698381 PMC: 11064246. DOI: 10.1186/s12913-024-10910-7.

Knowledge of Parents Working in Healthcare Settings Toward Attention-Deficit Hyperactivity Disorder Among Children.

Abuhammad S, ALAzzam M, Alabbasi Y J Multidiscip Healthc. 2024; 17:1043-1051.

PMID: 38481827 PMC: 10933522. DOI: 10.2147/JMDH.S452151.

Use of healthcare services before diagnosis of attention-deficit/hyperactivity disorder: a population-based matched case-control study.

Prasad V, Rezel-Potts E, White P, Downs J, Boddy N, Sayal K Arch Dis Child. 2023; 109(1):46-51.

PMID: 37903632 PMC: 10803994. DOI: 10.1136/archdischild-2023-325637.

Development and evaluation of an online education tool on attention deficit hyperactivity disorder for general practitioners: the important contribution of co-production.

French B, Daley D, Perez Vallejos E, Sayal K, Hall C BMC Fam Pract. 2020; 21(1):224.

PMID: 33131490 PMC: 7604955. DOI: 10.1186/s12875-020-01289-5.

References

Adamis D, Tatlow-Golden M, Gavin B, McNicholas F . General practitioners' (GP) attitudes and knowledge about attention deficit hyperactivity disorder (ADHD) in Ireland. Ir J Med Sci. 2018; 188(1):231-239. DOI: 10.1007/s11845-018-1804-3. View

Ginsberg Y, Beusterien K, Amos K, Jousselin C, Asherson P . The unmet needs of all adults with ADHD are not the same: a focus on Europe. Expert Rev Neurother. 2014; 14(7):799-812. DOI: 10.1586/14737175.2014.926220. View

French B, Sayal K, Daley D . Barriers and facilitators to understanding of ADHD in primary care: a mixed-method systematic review. Eur Child Adolesc Psychiatry. 2018; 28(8):1037-1064. PMC: 6675769. DOI: 10.1007/s00787-018-1256-3. View

French B, Daley D, Perez Vallejos E, Sayal K, Hall C . Development and evaluation of an online education tool on attention deficit hyperactivity disorder for general practitioners: the important contribution of co-production. BMC Fam Pract. 2020; 21(1):224. PMC: 7604955. DOI: 10.1186/s12875-020-01289-5. View

Luby J, Lenze S, Tillman R . A novel early intervention for preschool depression: findings from a pilot randomized controlled trial. J Child Psychol Psychiatry. 2011; 53(3):313-22. PMC: 3640820. DOI: 10.1111/j.1469-7610.2011.02483.x. View

Tatlow-Golden M, Prihodova L, Gavin B, Cullen W, McNicholas F . What do general practitioners know about ADHD? Attitudes and knowledge among first-contact gatekeepers: systematic narrative review. BMC Fam Pract. 2016; 17(1):129. PMC: 5013633. DOI: 10.1186/s12875-016-0516-x. View

Rughani A, Riley B, Rendel S . The future of GP specialty training: enhanced and extended. Br J Gen Pract. 2012; 62(599):288-9. PMC: 3361091. DOI: 10.3399/bjgp12X648972. View

Lee C, Tseng H, Wu L, Chuang Y . Multiple brief training sessions to improve nurses' knowledge, attitudes, and confidence regarding nursing care of older adults with depression in long-term care facilities. Res Nurs Health. 2019; 43(1):114-121. DOI: 10.1002/nur.21997. View

Sayal K, Prasad V, Daley D, Ford T, Coghill D . ADHD in children and young people: prevalence, care pathways, and service provision. Lancet Psychiatry. 2017; 5(2):175-186. DOI: 10.1016/S2215-0366(17)30167-0. View

10.

Daley D, Jacobsen R, Lange A, Sorensen A, Walldorf J . The economic burden of adult attention deficit hyperactivity disorder: A sibling comparison cost analysis. Eur Psychiatry. 2019; 61:41-48. DOI: 10.1016/j.eurpsy.2019.06.011. View

11.

McCarthy S, Wilton L, Murray M, Hodgkins P, Asherson P, Wong I . The epidemiology of pharmacologically treated attention deficit hyperactivity disorder (ADHD) in children, adolescents and adults in UK primary care. BMC Pediatr. 2012; 12:78. PMC: 3472167. DOI: 10.1186/1471-2431-12-78. View

12.

Christensen H, Griffiths K, Farrer L . Adherence in internet interventions for anxiety and depression. J Med Internet Res. 2009; 11(2):e13. PMC: 2762797. DOI: 10.2196/jmir.1194. View

13.

Lebowitz M . Stigmatization of ADHD: A Developmental Review. J Atten Disord. 2013; 20(3):199-205. DOI: 10.1177/1087054712475211. View

14.

Craig P, Dieppe P, Macintyre S, Michie S, Nazareth I, Petticrew M . Developing and evaluating complex interventions: the new Medical Research Council guidance. BMJ. 2008; 337:a1655. PMC: 2769032. DOI: 10.1136/bmj.a1655. View

15.

Lester H, Birchwood M, Freemantle N, Michail M, Tait L . REDIRECT: cluster randomised controlled trial of GP training in first-episode psychosis. Br J Gen Pract. 2009; 59(563):e183-90. PMC: 2688067. DOI: 10.3399/bjgp09X420851. View

16.

Ersser S, Cowdell F, Nicholls P, Latter S, Healy E . A pilot randomized controlled trial to examine the feasibility and efficacy of an educational nursing intervention to improve self-management practices in patients with mild-moderate psoriasis. J Eur Acad Dermatol Venereol. 2011; 26(6):738-45. DOI: 10.1111/j.1468-3083.2011.04158.x. View

17.

Moldavsky M, Sayal K . Knowledge and attitudes about attention-deficit/hyperactivity disorder (ADHD) and its treatment: the views of children, adolescents, parents, teachers and healthcare professionals. Curr Psychiatry Rep. 2013; 15(8):377. DOI: 10.1007/s11920-013-0377-0. View

18.

Young J, OHalloran A, McAulay C, Pirotta M, Forsdike K, Stacey I . Unconditional and conditional incentives differentially improved general practitioners' participation in an online survey: randomized controlled trial. J Clin Epidemiol. 2014; 68(6):693-7. DOI: 10.1016/j.jclinepi.2014.09.013. View

19.

Lewis N, Larkins C, Stanley N, Szilassy E, Turner W, Drinkwater J . Training on domestic violence and child safeguarding in general practice: a mixed method evaluation of a pilot intervention. BMC Fam Pract. 2017; 18(1):33. PMC: 5336644. DOI: 10.1186/s12875-017-0603-7. View

20.

Rosendal M, Olesen F, Fink P, Toft T, Sokolowski I, Bro F . A randomized controlled trial of brief training in the assessment and treatment of somatization in primary care: effects on patient outcome. Gen Hosp Psychiatry. 2007; 29(4):364-73. DOI: 10.1016/j.genhosppsych.2007.03.005. View