Objective: 

The aim of this study was to assess rates of primary care provider (PCP) diagnosis and treatment of school-age children with attention-deficit/hyperactivity disorder (ADHD) during the COVID-19 pandemic compared with prepandemic years and to investigate disparities in care.

Method: 

We retrospectively analyzed electronic health records from all primary care visits (in-person and telehealth) of children aged 6 to 17 years seen between January 2016 and March 2021 in a community-based primary health care network (n = 77,298 patients). Study outcomes are as follows: (1) number of primary care visits, (2) number of visits with ADHD diagnosis (ADHD-related visits), (3) number of PCP prescriptions for ADHD medications, (4) number of patients with first ADHD diagnoses, and (5) number of first PCP prescriptions of ADHD medications. Interrupted time series analysis evaluated changes in rates of study outcomes during 4 quarters of the pandemic year (March 15, 2020–March 15, 2021) compared with prepandemic years (January 1, 2016–March 14, 2020). Patient demographic characteristics during prepandemic and pandemic years were compared.

Results: 

ADHD–related visits dropped in the first quarter of the pandemic year by 33% (95% confidence interval, 22.2%–43.6%), returning to prepandemic rates in subsequent quarters. ADHD medication prescription rates remained stable throughout the pandemic year. Conversely, rates of first ADHD diagnoses and first medication prescriptions remained significantly lower than prepandemic rates. The proportion of ADHD-related visits for patients living in low-income neighborhoods was lower in the pandemic year compared with prepandemic years.

Conclusion: 

Ongoing treatment for school-age children with ADHD was maintained during the pandemic, especially in high-income families. Socioeconomic differences in ADHD-related care emphasize the need to improve access to care for all children with ADHD in the ongoing pandemic and beyond.

中文翻译：

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学龄儿童注意力缺陷/多动症的初级保健诊断和治疗：COVID-19 大流行期间的趋势和差异

客观的： 

本研究的目的是评估 COVID-19 大流行期间与大流行前年份相比，初级保健提供者 (PCP) 对患有注意力缺陷/多动障碍 (ADHD) 的学龄儿童的诊断和治疗率，并调查护理方面的差异。

方法： 

我们回顾性分析了 2016 年 1 月至 2021 年 3 月期间在社区初级卫生保健网络中看到的 6 岁至 17 岁儿童的所有初级保健就诊（现场和远程医疗）的电子健康记录（n = 77,298 名患者）。研究结果如下：(1) 初级保健就诊次数，(2) 诊断为 ADHD 的就诊次数（ADHD 相关就诊），(3) PCP 开出的 ADHD 药物处方数量，(4) 首次接受 ADHD 药物治疗的患者数量ADHD 诊断，以及 (5) PCP 首次开出 ADHD 药物处方的数量。间断时间序列分析评估了大流行年的四个季度（2020年3月15日至2021年3月15日）与大流行前年份（2016年1月1日至2020年3月14日）相比研究结果发生率的变化。比较了大流行前和大流行期间的患者人口特征。

结果： 

在大流行年份第一季度，与多动症相关的就诊量下降了 33%（95% 置信区间，22.2%–43.6%），在随后的几个季度恢复到大流行前的水平。多动症药物处方率在整个大流行年保持稳定。相反，首次 ADHD 诊断和首次药物处方率仍显着低于大流行前的比率。与大流行前年份相比，大流行年份居住在低收入社区的患者因多动症相关就诊的比例较低。

结论： 

在大流行期间，对患有多动症的学龄儿童的持续治疗得到维持，特别是在高收入家庭中。多动症相关护理的社会经济差异强调，在当前的大流行及以后，需要改善所有多动症儿童获得护理的机会。