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Implementation Science
Published in: Implementation Science 1/2014

Open Access 01-12-2014 | Study protocol

Improving patient care for attention deficit hyperactivity disorder in children by organizational redesign (Tornado program) and enhanced collaboration between psychiatry and general practice: a controlled before and after study

Authors: Mijnke Janssen, Michel Wensing, Rutger Jan van der Gaag, Ineke Cornelissen, Patricia van Deurzen, Jan Buitelaar

Published in: Implementation Science | Issue 1/2014

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Abstract

Background

Implementation of clinical guidelines for diagnosis and treatment of attention deficit hyperactivity disorder (ADHD) in children and adolescents is a challenge in practice due to insufficient availability of mental health specialists and lack of effective cooperation with primary care physicians. The Tornado program aims to reduce time between referral and start of treatment in eligible patients. This study aims to assess the effectiveness and efficiency of this program.

Methods/design

This is a non-randomized controlled before-after study involving 90 outpatients (6-18 years old) suspected of uncomplicated ADHD, which were recruited by ten mental health teams. The Tornado program, provided by three teams, combines accelerated-track diagnosis and treatment planning. This is followed by psychoeducation at a mental health center and pharmacological treatment by primary care physicians, who received an online e-learning module for this purpose. The control group consists of patients of seven other teams, who receive care as usual. Primary outcome is the patients' time between referral to the mental health or pediatric center and start of treatment. Secondary outcomes include severity of ADHD symptoms; functional status; health-related quality of life; treatment adherence; indicators of diagnostic procedures and treatments; patient, parent, and professional experiences and satisfaction with care; and an economic evaluation. The study is powered to detect a difference of 36 days.

Discussion

This study will provide insight into the effectiveness and efficiency of the Tornado program, an accelerated-track program in mental healthcare.

Trial registration

Netherlands Trial Register http://​www.​trialregister.​nl/​trialreg/​admin/​rctview.​asp?​TC=​2505. Trial status: active data collection.

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Metadata
Title
Improving patient care for attention deficit hyperactivity disorder in children by organizational redesign (Tornado program) and enhanced collaboration between psychiatry and general practice: a controlled before and after study
Authors
Mijnke Janssen
Michel Wensing
Rutger Jan van der Gaag
Ineke Cornelissen
Patricia van Deurzen
Jan Buitelaar
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Implementation Science / Issue 1/2014
Electronic ISSN: 1748-5908
DOI
https://doi.org/10.1186/s13012-014-0155-3

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