Book contents
- Frontmatter
- Contents
- Editors
- Contributors
- Foreword
- Preface
- Introduction
- Completing an audit project
- I Disorders
- II Legislation
- III Physical health
- 28 Diabetes: management
- 29 Infection control
- 30 Metabolic side-effects of antipsychotics
- 31 Metabolic syndrome
- 32 Monitoring growth and blood pressure in children with attention-deficit hyperactivity disorder
- 33 Physical examinations: equipment
- 34 Physical health of in-patients: assessment
- 35 Physical health of in-patients: record-keeping
- 36 Physical health of patients with severe mental illness
- 37 Screening for blood-borne viruses
- 38 Screening for breast and cervical cancer
- 39 Smoking cessation
- 40 Testing for illicit drug use
- 41 Venepuncture equipment
- IV Record-keeping
- V Service provision
- VI Training
- VII Treatment
- Appendices
32 - Monitoring growth and blood pressure in children with attention-deficit hyperactivity disorder
from III - Physical health
Published online by Cambridge University Press: 02 January 2018
- Frontmatter
- Contents
- Editors
- Contributors
- Foreword
- Preface
- Introduction
- Completing an audit project
- I Disorders
- II Legislation
- III Physical health
- 28 Diabetes: management
- 29 Infection control
- 30 Metabolic side-effects of antipsychotics
- 31 Metabolic syndrome
- 32 Monitoring growth and blood pressure in children with attention-deficit hyperactivity disorder
- 33 Physical examinations: equipment
- 34 Physical health of in-patients: assessment
- 35 Physical health of in-patients: record-keeping
- 36 Physical health of patients with severe mental illness
- 37 Screening for blood-borne viruses
- 38 Screening for breast and cervical cancer
- 39 Smoking cessation
- 40 Testing for illicit drug use
- 41 Venepuncture equipment
- IV Record-keeping
- V Service provision
- VI Training
- VII Treatment
- Appendices
Summary
Setting
The audit is of particular relevance to services that manage the treatment of attention-deficit hyperactivity disorder (ADHD) in young people and which specifically use both stimulant and non-stimulant medications. Background
The medication used to treat the symptoms of ADHD can suppress appetite and so affect the growth rate of children. It can also lead to tachycardia and raised blood pressure, both of which may affect the tolerability of the medication.
Standards
Standards were obtained from two sources, the Scottish Intercollegiate Guidelines Network (SIGN) (2009) and the National Institute for Health and Clinical Excellence (NICE) (2008). The former states that:
ᐅ Psychostimulants should be considered as the first line of drug treatment for the core symptoms of confirmed ADHD/hyperkinetic disorder.
ᐅ Once an effective dose has been determined, regular review continues to be important, for checks of behavioural rating and side-effects, along with checks of height, weight and blood pressure. The NICE standards state that, for people taking methylphenidate, atomoxetine or dexamfetamine:
ᐅ Height should be measured every 6 months in children and young people.
ᐅ Weight should be measured 3 and 6 months after drug treatment has started and every 6 months thereafter in children, young people and adults.
ᐅ Height and weight in children and young people should be plotted on a growth chart and reviewed by the healthcare professional responsible for treatment.
ᐅ Heart rate and blood pressure should be monitored and recorded on a centile chart before and after each dose change and routinely every 3 months.
Method
Data collection
All case files for children in the service with a diagnosis of ADHD were located. A random sample was selected, and information collected using a pro forma. The medical notes of the selected ADHD patients were examined for documentation of the following:
ᐅ demographic data including age, gender and consultant
ᐅ whether the child has been prescribed medication for ADHD
ᐅ whether the child has been reviewed at clinic
ᐅ presence of updated growth chart in the notes
ᐅ recordings of heart rate and blood pressure.
- Type
- Chapter
- Information
- 101 Recipes for Audit in Psychiatry , pp. 87 - 88Publisher: Royal College of PsychiatristsPrint publication year: 2011