Attitudes and practices of general practitioners in the diagnosis and management of attention-deficit/hyperactivity disorder

Objective: To assess understanding of, and actual and potential roles in management of attention-deficit/hyperactivity disorder (ADHD) among GPs. Methods: A cross-sectional questionnaire survey of Queensland GPs selected randomly from the Royal Australian College of General Practitioners directory of members was carried out. Main outcome measures were knowledge levels of ADHD, current management practices, referral patterns and self-perceived information and training needs. Results: Three hundred and ninety-nine GPs returned a completed questionnaire (response rate 76%). Roles identified by GPs were: the provisional diagnosis of ADHD and referral to specialist services for confirmation of the diagnosis and initiation of management; assistance with monitoring progress once a management plan was in place; education of the child and their family regarding the disorder; and liaison with the school where necessary. Perceived barriers to increased involvement of GPs were: time and resource constraints of general practice; concerns regarding abuse and addiction liability of prescription stimulants; complex diagnostic issues associated with childhood behavioural problems; and lack of training and education regarding ADHD. Conclusions: General practitioners identify a role for themselves in ADHD care that is largely supportive in nature and involves close liaison with specialist services.

Northern wing, General Purpose North 3, University of Queensland, St Lucia

As seen from Blair Road.

Northern wing, General Purpose North 3, University of Queensland, St Lucia

As seen from Balir Road.

West elevation, General Purpose North 3, University of Queensland, St Lucia

Formal elevation facing University of Queensland entrance roads.

Eastern edge, General Purpose North 3, University of Queensland, St Lucia

As seen from informal courtyard; Duhig Tower beyond.

West elevation, General Purpose North 3, University of Queensland, St Lucia

Formal elevation facing University of Queensland entrance roads.

West elevation, General Purpose North 3, University of Queensland, St Lucia

Formal elevation facing University of Queensland entrance roads.

West elevation, General Purpose North 3, University of Queensland, St Lucia

Formal elevation facing University of Queensland entrance roads.

Amphitheatre entry court, Collaborative Workshop, University of Queensland, St Lucia

Entry from landscaped amphitheatre area.

Amphitheatre entry court, Collaborative Workshop, University of Queensland, St Lucia

Entry from landscaped amphitheatre area.

Entry court, Hill House, Chapel Hill, Brisbane

As seen from front door stairs.

Prevalence of Parkinson’s disease in metropolitan and rural Queensland: A general practice survey

The prevalence of idiopathic Parkinson’s disease (IPD) in Australia is unclear. We estimated the prevalence of IPD, and other forms of parkinsonism, through the study of typical caseloads in general practice. A random sample of general practitioners (GPs) throughout Queensland (401 responses from 528 validated practice addresses) was asked to estimate the numbers of patients with IPD and parkinsonism seen in the preceding year. The estimated prevalence of diagnosed IPD in Queensland was 146 per 100 000 (95% CI = 136–155). A further 51 per 100 000 in the population were suspected by doctors to have IPD without formal diagnosis, whereas another 51 per 100 000 people may have non-idiopathic parkinsonism. Idiopathic Parkinson’s disease was more common in rural than metropolitan areas. Although most GPs were confident in making diagnoses of IPD, the majority had little or no confidence in their ability to treat the disease, especially in its later stages. Support from neurologists was perceived by GPs to be very good in cities, but poor in remote areas.