Attention deficit hyperactivity disorder management and diagnosis by GPs

How are we advocating for members?

RACGP member feedback shows that GPs want to be able to do more for their patients living with attention deficit hyperactivity disorder (ADHD). ADHD management is within the scope of general practice:

• Specialist GPs are well supported by appropriate prescribing guidelines
• ADHD is part of the current curriculum for RACGP GP training and GPs can access ADHD modules in our training platform
• GPs have been successfully supporting children with ADHD in Queensland for eight years and from 1 December will also be able to diagnose and treat adults
• GPs manage a diverse range of chronic conditions throughout our patients’ lives
• GPs are trained to identify when a case may be complex and requires referral to an appropriate non-GP specialist

Our role as providers of continuing, holistic care, positions GPs to support patients with ADHD.

Not every GP will want to prescribe medicine for ADHD, but GPs with an interest and the appropriate skills and training should be allowed to provide this care independently.

The RACGP’s position statement on ADHD can be found here.

To enhance ADHD healthcare in Australia, the RACGP is calling on the Federal Government to:

• facilitate national consistency by harmonising state and territory legislations to enable specialist GPs to initiate, modify and continue psychostimulant medications for adults and children with ADHD
• support through funding:
  • ongoing professional development, training and mentorship to ensure GPs have the tools to effectively diagnose and manage ADHD
  • increased Medicare rebates for longer consultations and increased flexibility for case conferencing to facilitate shared care discussions as well as a multidisciplinary approach to treatment
  • more research into ADHD including screening tools, shared care models, effective non-pharmacological therapies, longitudinal studies, and development of culturally appropriate assessment tools for Aboriginal and Torres Strait Islander peoples and those from culturally and linguistically diverse groups.

Psychostimulant medications are Schedule 8 (controlled) medicines and each state and territory in Australia has their own laws and regulations surrounding the prescription of these medicines. To date, these have generally restricted ADHD diagnosis and assessment to paediatricians and psychiatrists. This is a rapidly changing landscape with several state and territory government announcements of trials enabling GP prescribing.

Specialist GPs should seek individual advice from their medical indemnity insurer when making significant changes to the nature of their practice.

State and territory announcements

RACGP advocacy has been successful in several states and territories, with a number of governments announcing reforms to enable GPs to diagnose and treat ADHD.