The impact of Covid-19 pandemic on services for children and adolescents with ADHD: results from a survey of paediatricians in the United Kingdom

Michael O Ogundele; Hani F Ayyash; Cornelius Ani; Michael O Ogundele; Hani F Ayyash; Cornelius Ani

doi:10.3934/publichealth.2022037

AIMS Public Health

2022, Volume 9, Issue 3: 542-551. doi: 10.3934/publichealth.2022037

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Research article Topical Sections

The impact of Covid-19 pandemic on services for children and adolescents with ADHD: results from a survey of paediatricians in the United Kingdom

1.
Halton Community Pediatrics Unit, Bridgewater Community Healthcare NHS Foundation Trust, Runcorn UK
2.
Essex Partnership University Hospitals NHS Foundation Trust (EPUT), Lighthouse Child Development Centre, Southend-On-Sea, Essex, UK
3.
Division of Psychiatry, Imperial College London, UK
4.
Surrey and Borders Partnership NHS Foundation Trust
5.
Scientific Committee Member, British Paediatric Surveillance Unit, Royal College of Paediatrics and Child Health, UK
6.
George Still Forum (National Network for Paediatric ADHD and related Neurodevelopmental disorders)

Received: 03 February 2022 Revised: 20 May 2022 Accepted: 17 June 2022 Published: 21 June 2022

Background
The Covid-19 pandemic has led to huge disruptions and multi-domain healthcare crisis, with additional impact on children and young people (CYP) affected by Attention Deficit and Hyperactivity Disorder (ADHD).

Methods
We conducted an online survey and obtained responses from 62 Paediatricians who provide ADHD services for CYP about their experience of Service disruption and adaptations during the first Covid-19 lockdown in the United Kingdom between March and June 2020. The responses were both quantitative and qualitative.

Results
The Paediatricians reported huge service disruptions such that almost half ceased the assessment of new patients with ADHD, and only 5% were able to offer physical monitoring for most patients. However, all respondents had adopted telemedicine, which allowed them to maintain high levels of non-physical service provision for existing patients. The Paediatricians used risk stratification strategies to determine which patients were more likely to benefit from the limited available face to face appointments for physical monitoring. The Paediatricians demonstrated clinical pragmatism to meet the needs of their patients such as starting medication without physical exam especially if the patient's behaviour was so challenging that it was presenting a crisis at home, and setting aside monthly limits for stimulant medications. Some respondents reported helpful cross-service collaborations to support CYP with ADHD and their families.

Conclusion
The Covid-19 pandemic has had adverse effect on many CYP with ADHD and caused huge disruption to the ADHD services that support them. As the pandemic continues to cause disruptions to ADHD services, the service adaptations emerging from the literature including some of those identified in this study could be useful to support more stable and sustainable ADHD services, both during and after the pandemic.
- Covid-19,
- ADHD,
- service provision,
- disruption,
- child and adolescent mental health,
- paediatrics,
- telemedicine,
- United Kingdom
Citation: Michael O Ogundele, Hani F Ayyash, Cornelius Ani. The impact of Covid-19 pandemic on services for children and adolescents with ADHD: results from a survey of paediatricians in the United Kingdom[J]. AIMS Public Health, 2022, 9(3): 542-551. doi: 10.3934/publichealth.2022037

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Abstract

Background

The Covid-19 pandemic has led to huge disruptions and multi-domain healthcare crisis, with additional impact on children and young people (CYP) affected by Attention Deficit and Hyperactivity Disorder (ADHD).

Methods

We conducted an online survey and obtained responses from 62 Paediatricians who provide ADHD services for CYP about their experience of Service disruption and adaptations during the first Covid-19 lockdown in the United Kingdom between March and June 2020. The responses were both quantitative and qualitative.

Results

The Paediatricians reported huge service disruptions such that almost half ceased the assessment of new patients with ADHD, and only 5% were able to offer physical monitoring for most patients. However, all respondents had adopted telemedicine, which allowed them to maintain high levels of non-physical service provision for existing patients. The Paediatricians used risk stratification strategies to determine which patients were more likely to benefit from the limited available face to face appointments for physical monitoring. The Paediatricians demonstrated clinical pragmatism to meet the needs of their patients such as starting medication without physical exam especially if the patient's behaviour was so challenging that it was presenting a crisis at home, and setting aside monthly limits for stimulant medications. Some respondents reported helpful cross-service collaborations to support CYP with ADHD and their families.

Conclusion

The Covid-19 pandemic has had adverse effect on many CYP with ADHD and caused huge disruption to the ADHD services that support them. As the pandemic continues to cause disruptions to ADHD services, the service adaptations emerging from the literature including some of those identified in this study could be useful to support more stable and sustainable ADHD services, both during and after the pandemic.

Abbreviations

ADHD

Attention deficit and hyperactivity disorder

CAMHS

Child and adolescent mental health services

CYP

Children and young people

GSF

George-still forum

PPE

Personal protective equipment

Acknowledgments

We than members of GSF who participated in the survey.

Conflict of interest

The authors have no conflict of interest to declare.

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