This article series is a monthly tool to help physicians maximize patient health outcomes in accordance withNCQA's¹ HEDIS^®2 measurements for high quality care on important dimensions of services.

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HEDIS^® definition

Follow-up care for children prescribed ADHD medication:The percentage of children newly prescribed attention-deficit/hyperactivity disorder (ADHD) medication who had at leastthree follow-up care visits within a 10-month period, one ofwhich was within 30 days of when the first ADHD medicationwas dispensed.

Two rates are reported:

• Initiation Phase. The percentage of members ages 6 ? 12as of the IPSD* with an ambulatory prescription dispensedfor ADHD medication who had one follow-up visit with apractitioner prescribing authority during the 30-day InitiationPhase.
• Continuation and Maintenance (C&M) Phase. Thepercentage of members ages 6 ? 12 as of the IPSD withan ambulatory prescription dispensed for ADHD medicationwho remained on the medication for at least 210 days andwho, in addition to the visit in the Initiation Phase, had atleast two follow-up visits with a practitioner within270 days (9 months) after the Initiation Phase ended.

Why this measure is important

ADHD is one of the more common chronic conditions ofchildhood. Children with ADHD may experience significantfunctional problems, such as school difficulties; academicunderachievement; troublesome relationships with familymembers and peers; and behavioral problems. Given thehigh prevalence of ADHD among school-aged children(4 ? 12 percent), primary care clinicians will regularlyencounter children with ADHD and should have a strategyfor diagnosing and long-term management of this condition.

Practitioners can convey the efficacy of pharmacotherapyto their patients. American Psychiatric Association (APA)guidelines recommend that once a child is stable, an officevisit every three to six months allows assessment of learningand behavior. Follow-up appointments should be made atleast monthly until the child?s symptoms have been stabilized.? NCQA, HEDIS 2013 V1

ADHD medications

The chart below indicates the percentageof physicians, by specialty type, prescribingADHD medications.

In a six-month prescriber review formeasure-qualifying ADHD medications,71 percent of prescriptions were writtenby pediatricians and psychiatrists.

Increasing the follow-up rates for thesetwo specialties could drastically improveoverall measure improvement.

* The IPSD, or Index Prescription Start Date, is the earliestprescription dispensing date for an ADHD medication wherethe date is in the Intake Period and there is a NegativeMedication History.

¹ The National Committee for Quality Assurance (NCQA) is themost widely recognized accreditation program in the U.S.

² The Healthcare Effectiveness Data and Information Set(HEDIS) is an NCQA tool used by more than 90 percent of U.S. health plans to measure performance on importantdimensions of care.

HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA). Used with permission.