Improving Multimodal Care of Attention Deficit Hyperactivity Disorder in an Outpatient Psychiatry Clinic: A Quality Improvement Project

Despite leading medical associations recommending multimodal treatment for attention deficit hyperactivity disorder (ADHD), prescription stimulants often remain the only therapeutic approach. Amidst challenges posed by stimulant shortages, the underutilization of non-medication interventions contributes to less robust treatment outcomes. Limited provider training and the complexities of implementing multimodal care contribute to underutilization. This project aimed to address the gap by tailoring an evidence-based ADHD toolkit for mental health clinicians to improve their knowledge and proficiency in delivering multimodal treatment interventions for patients with ADHD. Local Problem: Mental health professionals in two outpatient general psychiatry clinics located in urban Utah report minimal ADHD-specific training, time, and resources to deliver multimodal treatment to patients with ADHD. Methods: Participants completed a questionnaire before the intervention to evaluate their current ADHD practices, training experiences, and barriers to implementing multimodal care. Following the intervention, a post-intervention questionnaire was distributed via email to gauge the effectiveness of the educational intervention and toolkit and clinician satisfaction. Intervention: A tailored toolkit was developed based on a literature review, pre-intervention questionnaires, clinician feedback, and guidelines by the American Academy of Family Physicians. An in-person educational PowerPoint and weekly emails provided further training, resources, and referrals. Results: Post-questionnaire respondents (100%, n=8) agreed that the project encouraged their use of multimodal care for treating ADHD and enhanced patient and family engagement in discussing ADHD treatment options. Post-questionnaire surveys demonstrated an increase in self-reported integration of behavioral and lifestyle interventions compared to pre-questionnaire surveys. Conclusion: The tailored ADHD toolkit increased clinicians' knowledge and positively impacted the delivery of multimodal treatment interventions for patients with ADHD. Future clinical practice may benefit from similarly tailored toolkits to improve healthcare professionals' knowledge and competency in delivering multimodal ADHD care.