The evaluation of attention deficit/hyperactivity disorder in family medicine residency programs

BACKGROUND: Previous studies have highlighted great variability in how primary care physicians arrive at the diagnosis of Attention Deficit/ Hyperactivity Disorder (ADHD) and their frequent use of unreliable methods. This study examines how physicians in family medicine residency programs evaluate for ADHD in light of the 2000 American Academy of Pediatrics ADHD Practice guidelines. METHODS: A 55-item survey was sent to 17 military and 17 civilian family medicine residency programs. Two hundred and thirty-five physicians participated. Descriptive statistics and chi-square analysis was performed. RESULTS: Only 22% of physicians are familiar with the AAP guidelines and only 12.9% of respondents screen for ADHD. 70% of physicians use a child's behavior in the office and 53% use a child's response to stimulants to arrive at a diagnosis. CONCLUSIONS: Four years after publication of the practice guidelines, few physicians incorporate them into their practice. A majority of physicians still use unreliable methods in diagnosing ADHD.