Monitoring effectiveness of medication

Domeena C. Renshaw, M.D., in her book “The Hyperactive Child,” provided an ADHD medication evaluation form to be used by children/their parents.

Regarding teachers sharing feedback directly with physicians, legally that may require full written disclosure and consent from the parents/children involved so as not to violate doctor/patient confidentiality. That’s my understanding.

The only persons who really know how the ADHD medicines really work are the patients themselves; with children, it can be difficult for many children to be able to verbalize everything about what an ADHD med may do/not do and so on.

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[quote=”scrunyon”]I am interested in talking with teachers who have had feedback opportunities to share information with physicians regarding the effectiveness of medication treatment for students with ADHD.
[email protected]
Steve[/quote]

I have had to fill out many checklists for physicians. They usually are given to the parent who gives consent and then gives them to me to fill out and return to the Dr. They are pretty subjective. I know a lot rests on the info I give to the Dr so I try to do the best I can. It can very easily be swayed one way or the other. A lot depends on how a child is perceived. I can see how easily teachers can get a child on meds if they are really “bugging” them. I wish there were another way to determine meds/dosage than this. I really don’t think it is fair to the kids. I would help the kid in any way possible rather than put them on meds.

Thanks for your response. I’m a school school psychologist and have frustrated with the lack of opportunity for teachers to give feedback to physicians regarding the effectiveness of medication and other treatments. I try to encourage parents to request the information from teachers. I often provide a “daily chart” that allows the teacher to rate 3 or 4 behaviors that she has prioritized. This data is available for the physician to review.

Additionally, I use the BASC TRS and PRS to gather data from parent and teacher regarding a variety of issues. Too often, the common characteristics of attention problems or impulsive behaviors are symptoms of other problems such as anxiety, depression, disorders of mood, ODD, and conduct disorders.

I use this approach as part of my contribution to “pre-referral activities” and general education intervention. This data is included in my comprehensive evaluation, if the student is referred for special education consideration. If the parents are interested in consulting with their physician, then I encourage them to share my written report with the doctor.

I sure that large hospitals and mental health centers have someone on staff to coordinate, collect, summarize, and share this data with the physician. However, the family physician is probably at a disadvantage. I would like to pilot a service that would provide needed information to the physician. Decisions regarding mediaction effectiveness would be based on feedback from the parent and teacher. Others such as the student or therapist could be included in this model. Below is brief summary of my idea.

[b]Treatment Management Systems[/b]
Treatment Management Systems will provide a practical, convenient, and effective system to obtain information from parents, school staff, and medical staff regarding the effectiveness of a student’s treatment plan during the school year. The staff at Treatment Management Systems will be responsible for obtaining and providing feedback to all parties involved in the treatment plan. By doing so, appropriate decisions regarding continuation or adjustments in treatment can be made based on input from a variety of sources. Doctors need feedback from teachers and parents. Parents need feedback from teachers regarding changes in student behavior/performance. Teachers need the opportunity to provide feedback to parents and physicians regarding changes in student behavior/performance. Treatment Management Systems will coordinate these efforts throughout the school year.

I would welcome your feedback regarding this idea.
Steve
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