In this study, we will follow, describe and revise implementation of a new model of collaboration for children and adolescents referred for ADHD assessment in the child and adolescent psychiatry in Odense. The model is called REHAB, it contains a citizen centered approach and is designed to ensure better coordination and collaboration between the clinical psychiatry and the social care obligations in municipalities. We will carry out a feasability study to ensure knowledge of implementation.
Attention-deficit Hyperactivity Disorder (ADHD) is a childhood-onset disorder with a prevalence of 3-5 %. A Danish national cohort study revealed that ADHD accounts for approximately one third of all mental disorders among children before the age of 18. ADHD is characterized by impairing inattention, motor hyperactivity, and impulsivity, which often leads to significant reduction in level of functioning and, as a consequence, more than half of those diagnosed with ADHD do not obtain an education equaling their potential and many become dependent of public support and relief.
The Danish Health Authority recommends that treatment and care is coordinated to ensure continuity and provide the best use of resources. Coordinated care and integrated care is a term of collaboration that is defined by the need for coordinating treatment and support between sectors, e.g., between hospital settings, municipality settings, general practitioners and other relevant stakeholders who can be involved in the treatment and care of individuals with complex needs.
It is recognized that the need for involving municipalities and the social sector in the treatment and support to children with ADHD is crucial for the Danish health care system to offer the best and most suitable services. Thus, well-organized integrated care collaboration models are suggested to help provide cross-sectorial treatment and care to individuals with complex care needs e.g., those diagnosed with ADHD.
This Ph.D. project aim to evaluate the implementation of the REHAB-model of collaboration. Our overall research question of interest is whether the REHAB-model of collaboration is feasible in relation to implementation and integration. Further, we are interested in the measurable effects of the REHAB- model on an individual quantitative level using Patient reported outcome(PRO) data. Here the research question of interest is whether pre-/post assessment with the chosen psychometrics: functional level (W-FIRS), quality of life (QoL) and ADHD-symptom severity (ADHD-RS) can quantify change and to what extent.
Description of the cohort
The REHAB-model of collaboration aims at ensuring high quality cross-sectorial treatment and care to children, adolescents and young adults referred for assessment of ADHD in the age range from 6 to 19 years. We will include children and adolescents from Odense, Middelfart and Kerteminde municipalities in the intervention, and controls will be samplet from 5 other municipalities from Fhunen.
Data and biological material
We will gather questionare data using chosen psychometrics: functional level (W-FIRS), quality of life (QoL) and ADHD-symptom severity (ADHD-RS). Further we will collect qualitative data in our process evaluation.