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Combining Care Management With Patient Portal Does Not Enhance ADHD Outcomes
Care management in addition to a patient portal did not enhance communication or improve symptoms in school-age children with attention-deficit/hyperactivity disorder (ADHD) beyond a patient portal alone, according to a comparative effectiveness study published in the journal Pediatrics.
“Both groups demonstrated similar reductions in ADHD symptoms over time,” wrote lead author James P. Guevara, MD, MPH, of the Children’s Hospital of Philadelphia, and coauthors. “Overall, there was variable engagement by parents with care managers, which likely limited its impact.”
The randomized clinical trial included 303 children with ADHD, ages 5 to 12, assigned to either care management combined with a patient portal or a patient portal alone over 9 months. The patient portal included family preferences and goals for treatment, medication side effects, and parent- and teacher-reported ADHD symptoms. Care managers communicated quarterly with parents, teachers, and clinicians; educated families; and coordinated care.
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Researchers found no significant differences over time in parent-reported outcomes between the 2 groups. Parents in the care management group had inconsistent communication with care managers but used the patient portal similarly to those in the portal alone group.
Families that attended 2 or more care manager sessions had significantly greater decreases in Vanderbilt Parent Rating Scale scores compared with those with fewer sessions, according to the study, suggesting greater engagement led to greater symptom improvement.
Overall, engagement by parents and teachers with care managers was modest.
“Care managers were instructed to engage with parents and teachers virtually at least every 3 months; however, care managers found it challenging to contact parents and teachers to schedule sessions. In some instances, care managers were unable to identify contact information for teachers despite calls to schools,” researchers wrote. “Given the virtual nature of the care management intervention in this study, face-to-face contact was lacking and may have contributed to the inconsistent engagement.”
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