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Parcours de soins dans le trouble déficit de l'attention avec hyperactivité chez l'enfant et l'adolescent : données probantes actuelles et pratiques de mise en œuvre
Mémoire de Master / Thèse d'exercice   Open Access

Parcours de soins dans le trouble déficit de l'attention avec hyperactivité chez l'enfant et l'adolescent : données probantes actuelles et pratiques de mise en œuvre

Arnaud Carlier
Masters , Université de Montpellier
16/10/2023

Résumé

Healthcare pathway Stepped care Multidisciplinary teams Primary cares Tertiary cares ADHD Psychiatrie de l’enfant et de l’adolescent Parcours de soins Gradation des soins Équipe pluridisciplinaire Soins primaires Soins tertiaires TDAH Soins secondaires Secondary cares
Attention deficit disorder with/without hyperactivity (ADHD) is the most common neurodevelopmental disorder in children and adolescents. Despite evidence regarding the effectiveness of its treatment, only a minority of children have access to proper care. This is why the establishment of aspecific treatment path for ADHD is a public health issue. The objective of this study is to describe our treatment path in scheduled consultation, in a secondary and tertiary care center in France with a focus on ADHD. Method: the study concerns patients aged 6 to 16, referred to our department for a first assessment in 2022. We studied the population’s characteristics, origin, medical follow-ups and treatment initiated in our department in the first year.Results: patients with ADHD represent 66.9% (334) of the total population (499). The average age for men is 9.2 years and for women 10.2 years. ADHD children aged 6-11 represent 77.2% of the population. The assessment is requested by parents for 31.1% of cases, by schools (30.5%) and by primary care (23.1%). Nurses carried out the first assessment of 43.1% of ADHD cases and doctors for 35% of them. 36.2% of patients with ADHD benefit from a multidisciplinary assessment. Parental therapy groups specific to ADHD are offered to 78% of families, of whom 19.4% participated. Treatment with methylphenidate was proposed to 47.6% of the patient population. In total, the MPEA tracks and follows 85% of ADHD cases. Conclusion: our study contributes to the development and implementation of an ADHD care pathway in accordance with current international guidelines and adapted to the French healthcare system. It supports the interest in the establishment of a dynamic internal gradation, the intervention of multidisciplinary teams allowing a complete evaluation, easy access to psychoeducation and the proposal of a wide therapeutic range.

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