Adult attention deficit hyperactivity disorder clinic: An interprofessional collaboration

Abstract

ObjectiveTo review the experience of a pharmacist-led interprofessional attention deficit hyperactivity disorder (ADHD) clinic in a large integrated health care system. Practice descriptionKaiser Permanente Northwest (KPNW) is a nonprofit managed health care system that provides integrated care to more than 625,000 members in Oregon and southwest Washington. Most health care encounters occur within KPNW facilities and with KPNW health professionals or support staff using a common electronic medical record. Practice innovationA team-based adult ADHD service was implemented with collaboration among the mental health, primary care, and pharmacy departments. EvaluationThe patients were assessed by a psychiatrist for diagnosis and care guidance. MethodsA pharmacist, working under the collaborative drug therapy management partnership, then initiated and managed the patient’s medications through telephone encounters until the patient was stable. The care of the patient was then transitioned back to primary care and not added to psychiatry’s caseload. ResultsA total of 914 patients were treated by the adult ADHD clinic since the initiation of the service in the fall of 2015. Of these patients, 610 were stabilized successfully by the ADHD clinic pharmacists. The ADHD clinic pharmacists conducted 2634 patient encounters over the study period and averaged 3.7 telephone follow-ups per successful patient, with follow-ups approximately every 2 weeks. The organization realized a cost savings of $761,280 during this time period on the basis of the cost of a mental health provider adjusting and addressing ADHD medications versus pharmacy staff working to stabilize the patient. ConclusionThe implementation of a collaborative adult ADHD service has demonstrated a successful alliance of primary care, mental health, and pharmacy in a large managed care organization. In addition to increased efficiency and evidence-based practice, the adult ADHD clinic resulted in cost savings and improved access to mental health care.