Authors:

^aPediatra. Unidad de Investigación y Eficiencia Clínica. CS Puerta Blanca. Málaga. España.

Correspondence: A Lora. Email: alora@telefonica.net

Reference of this article.:

Lora Espinosa A. El tratamiento del niño y adolescente con TDAH en Atención Primaria desde el punto de vista de la evidencia. Rev Pediatr Aten Primaria. 2006;8 Supl 4:S69-114.

Published in Internet: 31/12/2006

Abstract:

Paediatricians in Primary Care are the first professionals who assess the child with a possible attention deficit hyperactivity disorder (ADHD). Once the diagnosis is established, their responsibility is to initiate and/or follow-up an optimal treatment, with demonstrated efficacy by the scientific community, individualized to each case in order to minimize risks; cost-effective and taking into account the opinion of informed patients. Methods: an updated bibliographic review is presented in this paper with the evidences available through the last ten years concerning the efficacy, safety, efficiency and other features related to the ADHD treatment, with the purpose of facilitating the decision-making process in Primary Health Care. Results: the child with ADHD has an important morbidity and should be treated. The key elements of this treatment are: an action plan, education, pharmacological treatment, non-pharmacological treatment and periodical follow-up. Due to its efficacy, safety and cost-effectiveness, the recommended treatment is methylphenidate. For comorbidities related to behaviour disorders and dysfunctional families, psychosocial interventions are indicated. Learning disorders must be assessed and treated in the school environment. Periodical follow-up is needed for monitoring the outcomes of the treatment and for identifying barriers to treatment adherence. If the indicated treatment doesn?t reach the objectives or additional resources non-available at the Primary Care level are needed, the patient must be referred to specialized care.

Keywords: Attention deficit disorder with hyperactivity. Therapy. Cognitive therapy. Behaviour therapy. Cognitive therapy. Methylphenidate. Practice guidelines. Safety. Primary Health Care. Atomoxetin.

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The treatment of the child and adolescent with ADHD in Primary Care from the point of view of the evidence