{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T20:11:32Z","timestamp":1769631092085,"version":"3.49.0"},"reference-count":26,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,7,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVES:<\/jats:title>\n                  <jats:p>Medication management of attention-deficit\/hyperactivity disorder (ADHD) is often suboptimal. We examined whether (1) brief physician training plus computer-assisted medication management led to greater reduction in ADHD symptoms and (2) adherence to the recommended titration protocol produced greater symptomatic improvement.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>A randomized medication trial was conducted that included 24 pediatric practices. Children who met criteria for ADHD were randomly assigned by practice to treatment-as-usual or a specialized care group in which physicians received 2 hours of didactic training on medication management of ADHD plus training on a software program to assist in monitoring improvement. Parent and teacher reports were obtained before treatment and 4, 9, and 12 months after starting medication.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>Children in both specialized care and treatment-as-usual groups improved on the ADHD Rating Scales and SNAP-IV, but there were no group differences in improvement rates. Brief physician training alone did not produce improvements. When recommended titration procedures were followed, however, outcomes were better for total and inattentive ADHD symptoms on both the ADHD Rating Scales and SNAP-IV parent and teacher scales. Results were not attributable to discontinuation because of adverse effects or failure to find an effective medication dose.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>Brief physician training alone did not lead to reductions in ADHD symptoms, but adherence to a protocol that involved titration until the child's symptoms were in the average range and had shown a reliable change led to better symptom reduction. Computer-assisted medication management can contribute to better treatment outcomes in primary care medication treatment of ADHD.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2010-2684","type":"journal-article","created":{"date-parts":[[2011,6,14]],"date-time":"2011-06-14T00:14:18Z","timestamp":1308010458000},"page":"e46-e53","source":"Crossref","is-referenced-by-count":15,"title":["Computer-Assisted Management of Attention-Deficit\/Hyperactivity Disorder"],"prefix":"10.1542","volume":"128","author":[{"given":"John V.","family":"Lavigne","sequence":"first","affiliation":[{"name":"Departments of Child and Adolescent Psychiatry and"},{"name":"Feinberg School of Medicine, Northwestern University, Chicago, Illinois; and"},{"name":"Mary Ann and J. Milburn Smith, Child Health Research Program, Children's Memorial Research Center, Chicago, Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mina K.","family":"Dulcan","sequence":"additional","affiliation":[{"name":"Departments of Child and Adolescent Psychiatry and"},{"name":"Feinberg School of Medicine, Northwestern University, Chicago, Illinois; and"},{"name":"Mary Ann and J. Milburn Smith, Child Health Research Program, Children's Memorial Research Center, Chicago, Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan A.","family":"LeBailly","sequence":"additional","affiliation":[{"name":"Feinberg School of Medicine, Northwestern University, Chicago, Illinois; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen J.","family":"Binns","sequence":"additional","affiliation":[{"name":"Feinberg School of Medicine, Northwestern University, Chicago, Illinois; and"},{"name":"Mary Ann and J. Milburn Smith, Child Health Research Program, Children's Memorial Research Center, Chicago, Illinois"},{"name":"Pediatrics, Children's Memorial Hospital, Chicago, Illinois;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas K.","family":"Cummins","sequence":"additional","affiliation":[{"name":"Departments of Child and Adolescent Psychiatry and"},{"name":"Feinberg School of Medicine, Northwestern University, Chicago, Illinois; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Poonam","family":"Jha","sequence":"additional","affiliation":[{"name":"Departments of Child and Adolescent Psychiatry and"},{"name":"Feinberg School of Medicine, Northwestern University, Chicago, Illinois; and"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2011,7,1]]},"reference":[{"issue":"10","key":"2021120900044305900_B1","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1177\/070674379904401008","article-title":"Appropriateness of psychostimulant prescription to children: theoretical and empirical perspectives","volume":"44","author":"Miller","year":"1999","journal-title":"Can J Psychiatry"},{"issue":"5","key":"2021120900044305900_B2","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.1542\/peds.105.5.1158","article-title":"Clinical practice guideline: diagnosis and evaluation of the child with attention-deficit\/hyperactivity disorder","volume":"105","author":"American Academy of Pediatrics","year":"2000","journal-title":"Pediatrics"},{"issue":"4","key":"2021120900044305900_B3","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1542\/peds.108.4.1033","article-title":"Clinical practice guideline: treatment of the school-aged child with attention-deficit\/hyperactivity disorder","volume":"108","author":"American Academy of Pediatrics. 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