Attention deficit hyperactivity disorder (ADHD) is a disorder marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. ADHD is the most common neurobehavioral health condition in childhood and the disorder can continue through adolescence into adulthood. According to a 2020 data brief from the National Center for Health Statistics: Black children aged 3 to 17 years are more likely to have ever been diagnosed with ADHD or a learning disability (16.9 percent) compared to white (14.7 percent) and Hispanic children (11.9 percent). According to the National Institute of Mental Health (NIMH), ADHD has three subtypes: predominantly hyperactive-impulsive, predominantly inattentive, or combined hyperactive-impulsive and inattentive. Currently available treatments focus on reducing the symptoms of ADHD and improving functioning. Timely reassessment of children with newly prescribed ADHD medication is particularly important.

NCQA HEDIS evaluates two measures in the management of ADHA:

Initiation Phase (30 days): The percentage of children 6 to 12 years of age with an ambulatory prescription dispensed for ADHD medication, who had one follow-up visit with a practitioner with prescribing authority during the 30-day initiation phase.

Continuation & Maintenance Phase (9 months): The percentage of children 6 to 12 years of age with an ambulatory prescription dispensed for ADHD medication, who remained on the medication for at least 210 days and who, in addition to the visit in the initiation phase, had at least two follow-up visits with a practitioner with prescribing authority within 9 months after the initiation phase ended.

Clinical practice guidelines for the diagnosis and treatment of ADHD are published by the American Academy of Child and Adolescent Psychiatry (AACAP) and the American Academy of Pediatrics. The AACAP Official Action published Practice Parameter for the Assessment and Treatment of Children and Adolescents with Attention-Deficit/Hyperactivity Disorder with: Key Points; Diagnosis and Evaluation Algorithm; Treatment Algorithm Criteria for Diagnosis; and Medication Tables.

 

Last review date: November 1, 2021