Differences in Primary Care Management of Patients With Adult Attention Deficit Hyperactivity Disorder (ADHD) Based on Race and Ethnicity.

Objective: Examine differences in care patterns around adult ADHD between race (White/Non-White) and ethnic (Hispanic/Non-Hispanic) groups utilizing existing quality measures (QMs), concerning diagnosis, treatment, and medication prescribing.
Methods: The AAFP National Research Network in partnership with SUNY Upstate Medical used an EHR dataset to evaluate achievement of 10 ADHD QMs. The dataset was obtained from DARTNet Institute and includes 4 million patients of 873 behavioral and primary care practices with at least 100 patients from 2010 to 2020. Patients 18-years or older with adult ADHD were included in this analysis.
Results: White patients and Non-Hispanic/Latinx patients were more likely to achieve these QMs than Non-White patients and Hispanic/Latinx patients, respectively. Differences between groups concerning medication and monitoring demonstrate a disparity for Non-White and Hispanic/Latinx populations.
Conclusions: Using QMs in EHR data can help identify gaps in ADHD research. There is a need to continue investigating disparities of quality adult ADHD care.
Competing Interests: Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Over the past 3 years, Ms. Alai received research support from PCORI, Abbott, Eli Lilly, and Otsuka.Over the past 3 years, Dr. Callen received research support from PCORI, Merck, NIH, AAFP Foundation, Otsuka, Takeda, UnitedHealth Foundation, HRSA, GlaxoSmithKline, SAMHSA, Eli Lilly, CDC, Helmsley Foundation, and VaxCare.Over the past 3 years, Ms. Clay has received research support from NIH, Otsuka, Takeda, UnitedHealth Foundation, HRSA, SAMHSA, Eli Lilly and AAFP Foundation.Over the past 3 years, Dr. Goodman received honoraria, consulting income, potential income or travel expenses from Tris, Otsuka, Ironshore, Supernus, Sunovion, Noven, Shionogi, Ondosis, Medscape, HCPlive, Clinical Care Solutions, National Football League, WebMD, and the Neuroscience Education Institute.Over the past 3 years Dr. Adler is a consultant for Takeda, Otsuka, Bracket/Signant, Major League Baseball, the National Football League, and the State University of New York; receives grants from Takeda and Otsuka; and royalty payments from New York University School of Medicine for scales and training material for adult attention-deficit/hyperactivity disorders.Over the past 3 years, Mr. Shields received research support from PCORI, Merck, Humana, NIH, and AAFP Foundation.Over the past 3 years, Dr. Faraone received income, potential income, travel expenses continuing education support and/or research support from Aardvark, Aardwolf, AIMH, Tris, Otsuka, Ironshore, Kanjo, Johnson & Johnson/Kenvue, KemPharm/Corium, Akili, Supernus, Atentiv, Noven, Sky Therapeutics, Axsome, Genomind, Shire/Takeda, Arbor, Medice, Ondosis, Rhodes, and Vallon. With his institution, he has US patent US20130217707 A1 for the use of sodium-hydrogen exchange inhibitors in the treatment of ADHD. He also receives royalties from books published by Guilford Press: Straight Talk about Your Child’s Mental Health; Oxford University Press: Schizophrenia: The Facts; and Elsevier: ADHD: Non-Pharmacologic Interventions. He is Program Director of www.ADHDEvidence.org and www.ADHDinAdults.com. Dr. Faraone is supported by the European Union’s Horizon 2020 research and innovation programme under grant agreement No 965381; NIMH grants U01AR076092-01A1, 1R21MH1264940, R01MH116037; 1R01NS128535—01; Oregon Health and Science University, Otsuka Pharmaceuticals, Noven Pharmaceuticals Incorporated, and Supernus Pharmaceutical Company.