ADHD in AUS

Tackling the issue of ADHD in Australia

BeyondGP is an organisation committed to transforming the way that General Practice is taught and perceived throughout Australia

Mission

BeyondGP is an organisation privately founded and developed by Dr. Carmel O’Toole and Dr. Shelley Gray. It is entirely independent of any third party/pharmaceutical company funding.

The first goal of Beyond GP is embedding GPs into the heart of ADHD coordination and management in Australia

The Primary Issue

Undiagnosed and untreated ADHD is a medical, economic, and public health crisis in Australia.

The condition is poorly understood and poorly characterised.

Lack of education on the subject is affecting millions of Australians and creating poorer outcomes throughout general practice. 

The soon to be released National Guidelines for diagnosis and treatment of ADHD (developed by AADPA) will place general practitioners at the forefront of diagnosis and management.

Currently GPs in Australia are not equipped and sufficiently educated to fulfil this role.

… and this is because ADHD is fundamentally misunderstood on a systemic scale.
Were this education deficit to be addressed, GPs in Australia will be able to secure profoundly life changing results and clinical outcomes for many of their patients
(while alleviating a significant amount personal and professional strain).

The incidence of ADHD is estimated at approximately 5%. Taking the current Australian population as 25.6 million people, this equates to nearly 1.3 million Australians who are likely currently suffering with ADHD.

Currently Australia lacks the fundamental resources to appropriately treat and manage such a volume of ADHD patients. 

To attempt to do so with what is presently available would push already taxed infrastructure to collapse.

Australia simply cannot adequately manage the ADHD epidemic without including appropriately trained and informed GPs.

In order to do so GPs must have requisite training and understanding of the condition. 

BeyondGP training programs exist to bridge this gap

Detailed needs assessment

Attention Deficit-Hyperactivity Disorder (ADHD) has been recognised to affect at least 4% of Australian adults, with even higher representation in children (1). The current cost of ADHD to the Australian community is estimated to exceed $20 Billion dollars per annum (2).
ADHD presents in general practice every day, often with complex, poorly managed health conditions which lead to a variety of poor patient outcomes (3). These include (but are not limited to): over-representation in the public justice systems, decreased patient quality of life, increased burden on public health systems and premature mortality (3, 4). Australians seeking help for ADHD currently face extremely long waiting times due to the shortage of appropriately trained practitioners (5).
Early detection of ADHD improves treatment outcomes and reduces risks of substance use and criminal involvement (4). Conservatively, the number of currently undetected and thus, untreated cases of ADHD in Australia is approximately 1.25 million people (2).
GPs interest and need for training in ADHD is exemplified by the attendances at the Webinar series conducted by the RACGP Special Interest Group in ADHD and Neurodiversity (March 2023) where more than 1,000 GPs registered for the Adult Webinar conducted by Dr. Carmel O’Toole (a record number of applicants).

The recently released Australian ADHD Professional Association (AADPA) clinical guidelines for ADHD, endorsed by the NHMRC, highlight the important role for appropriately trained professionals in diagnosis and screening of ADHD (6). Fortunately, validated screening questionnaires have been developed which have high specificity for detection of ADHD (7, 8). Unfortunately, very few GPs in Australia are aware of the existence of these validated tools, let alone appropriately trained in their correct administration (9).
The BeyondGP training course introduces the best-practice screening questionnaires which are freely available, effective, and (upon completion of appropriate training) straightforward to administer. Widespread adoption of these screening tools in conjunction with appropriate training in their administration, will translate to substantial positive health outcomes for patients and GPs alike. The course also introduces GPs to recommended investigations and examinations to enhance ADHD patient management outcomes. ADHD behavioural changes and impairments are Page 1 of 3 correlated with known neuroanatomical functional changes and GPs are encouraged to adopt an evidence-based, public health approach to their role in ADHD management.

ADHD is core general practice in Australia, today.

References

1. Antshel KM, Barkley R. Attention deficit hyperactivity disorder. Handb Clin Neurol. 2020;174:37-45.

2. Deloitte. The social and economic costs of ADHD in Australia: Report prepared for the Australian ADHD Professionals Association. Deloitte Access Economics; 2019 July.

3. Faraone SV, Banaschewski T, Coghill D, Zheng Y, Biederman J, Bellgrove MA, et al. The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder. Neurosci Biobehav Rev. 2021;128:789-818.

4. Shaw M, Hodgkins P, Caci H, Young S, Kahle J, Woods AG, et al. A systematic review and analysis of long-term outcomes in attention deficit hyperactivity disorder: effects of treatment and non-treatment. BMC Med. 2012;10:99.

5. Massuti R, Moreira-Maia CR, Campani F, Sônego M, Amaro J, Akutagava-Martins GC, et al. Assessing undertreatment and overtreatment/misuse of ADHD medications in children and adolescents across continents: A systematic review and meta-analysis. Neurosci Biobehav Rev. 2021;128:64-73.

6. May T, Birch E, Chaves K, Cranswick N, Culnane E, Delaney J, et al. The Australian evidence-based clinical practice guideline for attention deficit hyperactivity disorder. Aust N Z J Psychiatry. 2023:48674231166329.

7. Brevik EJ, Lundervold AJ, Haavik J, Posserud MB. Validity and accuracy of the Adult Attention-Deficit/Hyperactivity Disorder (ADHD) Self-Report Scale (ASRS) and the Wender Utah Rating Scale (WURS) symptom checklists in discriminating between adults with and without ADHD. Brain Behav. 2020;10(6):e01605.

8. Espirito Santo H, Duarte C, Sério C, Lemos L. Validation of the Jasper/Goldberg Adult ADD Screening Examination -Version 5.0 in a sample of the Portuguese population2019.

9. Tatlow-Golden M, Prihodova L, Gavin B, Cullen W, McNicholas F. What do general practitioners know about ADHD? Attitudes and knowledge among first-contact gatekeepers: systematic narrative review. BMC Fam Pract. 2016;17(1):129.

References

1. Antshel KM, Barkley R. Attention deficit hyperactivity disorder. Handb Clin Neurol. 2020;174:37-45.

2. Deloitte. The social and economic costs of ADHD in Australia: Report prepared for the Australian ADHD Professionals Association. Deloitte Access Economics; 2019 July.

8. Espirito Santo H, Duarte C, Sério C, Lemos L. Validation of the Jasper/Goldberg Adult ADD Screening Examination -Version 5.0 in a sample of the Portuguese population2019.