The Australian evidence-based clinical practice guideline for attention deficit hyperactivity disorder

Tamara May; Edwina Birch; Karina Chaves; Noel Cranswick; Evelyn Culnane; Jane Delaney; Maddi Derrick; Valsamma Eapen; Chantele Edlington; Daryl Efron; Tatjana Ewais; Ingrid Garner; Michael Gathercole; Karuppiah Jagadheesan; Laura Jobson; John Kramer; Martha Mack; Marie Misso; Cammi Murrup-Stewart; Evan Savage; Emma Sciberras; Bruce Singh; Renee Testa; Lisa Vale; Alyssa Weirman; Edward Petch; Katrina Williams; Mark Bellgrove

doi:10.1177/00048674231166329

The Australian evidence-based clinical practice guideline for attention deficit hyperactivity disorder

Aust N Z J Psychiatry. 2023 Aug;57(8):1101-1116. doi: 10.1177/00048674231166329. Epub 2023 May 30.

Authors

Tamara May¹, Edwina Birch², Karina Chaves³, Noel Cranswick^{4

5

6}, Evelyn Culnane⁷, Jane Delaney⁸, Maddi Derrick⁹, Valsamma Eapen¹⁰, Chantele Edlington⁸, Daryl Efron^{5

7

11}, Tatjana Ewais^{12

13}, Ingrid Garner¹⁴, Michael Gathercole¹⁵, Karuppiah Jagadheesan^{16

17

18}, Laura Jobson¹⁹, John Kramer^{20

21}, Martha Mack²², Marie Misso²³, Cammi Murrup-Stewart¹⁹, Evan Savage²⁴, Emma Sciberras^{5

25}, Bruce Singh²⁶, Renee Testa^{27

28}, Lisa Vale²⁹, Alyssa Weirman¹⁴, Edward Petch^{30

31}, Katrina Williams^{1

32}, Mark Bellgrove^{19

33}

Affiliations

¹ Department of Paediatrics, Monash University, Clayton, VIC, Australia.
² ADHD Foundation, Epping, NSW, Australia.
³ Albury Wodonga Health, Albury, NSW, Australia.
⁴ Clinical Pharmacology Unit, Department of Medicine and Melbourne Children's Trials Centre, Royal Children's Hospital, Parkville, Vic, Australia.
⁵ Murdoch Children's Research Institute, Parkville Vic, Australia.
⁶ University of Melbourne, Parkville, VIC, Australia.
⁷ The Royal Children's Hospital Melbourne, Parkville, VIC, Australia.
⁸ Speech Pathology Australia, Melbourne, VIC, Australia.
⁹ Hobart ADHD Consultants, Bellerive, TAS, Australia.
¹⁰ South Western Sydney Local Health District and Ingham Institute for Applied Medical Research, UNSW Sydney, Liverpool, NSW, Australia.
¹¹ Department of Paediatrics, University of Melbourne, Parkville, VIC, Australia.
¹² Faculty of Medicine, University of Queensland, Herston, QLD, Australia.
¹³ School of Medicine and Dentistry, Griffith University, Southport, QLD, Australia.
¹⁴ ADHD Guideline Development Group, Melbourne, VIC, Australia.
¹⁵ Youth Justice, Department of Community and Justice, Grafton, NSW, Australia.
¹⁶ NWAMHS-North West Area Mental Health Services, Melbourne, VIC, Australia.
¹⁷ Bi-National ADHD Network Committee, RANZCP - Royal Australian and New Zealand College of Psychiatrists, Melbourne, VIC, Australia.
¹⁸ Swinburne University, Melbourne, VIC, Australia.
¹⁹ Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC, Australia.
²⁰ ADHD, ASD and Neurodiversity Special Interest Group, Faculty of Special Interests, RACGP.
²¹ Rural Medical School, UNSW Medicine & Health, Coffs Harbour, NSW, Australia.
²² Applied Neuroscience Society of Australasia (ANSA).
²³ The Knowledge Synthesis Lab, Melbourne, VIC, Australia.
²⁴ Department of Education, VIC, Australia.
²⁵ School of Psychology, Deakin University, Burwood, VIC, Australia.
²⁶ Department of Psychiatry, The University of Melbourne, Parkville, VIC, Australia.
²⁷ Department of Mental Health, Royal Children's Hospital, Melbourne, VIC, Australia.
²⁸ Department of Psychology, Monash University, Melbourne, VIC, Australia.
²⁹ Occupational Therapy Australia, Splash Paediatric Therapy, Melbourne, VIC, Australia.
³⁰ Hakea Prison, Department of Justice, Perth, WA, Australia.
³¹ University of Western Australia, Perth, WA, Australia.
³² Monash Children's Hospital, Clayton, VIC, Australia.
³³ AADPA Australian ADHD Professionals Association, Melbourne, VIC, Australia.

Abstract

Objective: The objective of this article was to provide an overview of the development and recommendations from the Australian evidence-based clinical practice guideline for attention deficit hyperactivity disorder (ADHD). The guideline aims to promote accurate and timely identification and diagnosis, and optimal and consistent treatment of ADHD.

Methods: Development integrated the best available evidence with multidisciplinary clinical expertise and the preferences of those with lived experience, underpinned by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework. The 23 guideline development group members included psychiatrists, paediatricians, general practitioners, psychologists, speech pathologists, occupational therapists, educators, Indigenous psychologists, and people with a lived experience; with two independent chairs and a methodologist. Where appropriate, evidence reviews from the National Institute for Health and Care Excellence (NICE) 2018 'Attention Deficit Hyperactivity Disorder: Diagnosis and Management' guideline were updated. Fifty prioritised clinical questions were addressed in 14 systematic reviews (new and updated from NICE 2018) and 28 narrative reviews.

Results: The 113 clinical recommendations apply to young children (5 years and under), children, adolescents and adults. They provide guidance for clinicians on identification, screening, diagnosis, multimodal treatment and support, including pharmacological and non-pharmacological interventions. The guideline and supporting information are available online: https://adhdguideline.aadpa.com.au/.

Conclusions: The guideline was approved by the National Health and Medical Research Council (NHMRC) of Australia and relevant medical and allied health professional associations. It is anticipated that successful implementation and uptake of the guideline by organisations, health care providers and other professionals will increase delivery of evidence-based treatment and improve health outcomes for the more than 800,000 Australians with ADHD.

Keywords: Attention deficit hyperactivity disorder; guideline; neurodevelopmental disorder.

Publication types

Review

MeSH terms

Adolescent
Adult
Attention Deficit Disorder with Hyperactivity* / diagnosis
Attention Deficit Disorder with Hyperactivity* / therapy
Australia
Child
Child, Preschool
Evidence-Based Practice
General Practitioners*
Humans
Psychiatry*