— Results of recent CEPAC meeting translated into Action Guide for Parents, Physicians and Insurers –
Boston, Mass., August 6, 2012 – Votes taken at a recent meeting of the New England Comparative Effectiveness Public Advisory Council (CEPAC) have emphasized the strength of evidence supporting parent behavior training (PBT) as an effective first-line treatment for most preschool-age children with Attention Deficit Hyperactivity Disorder (ADHD).   For older, school-age children with ADHD, CEPAC noted that the strongest available evidence supports the use of methylphenidate (e.g. Ritalin®), with or without combined behavioral interventions.  Because parents of children with ADHD often struggle with choosing the best treatment options for the condition, and busy primary care physicians do not always have access to the latest evidence on what works best, a user-friendly Action Guide summarizing the CEPAC findings has been released.  The Action Guide presents a list of specific evidence-based steps for patients’ families, clinicians, and insurers that will improve patient outcomes and the overall value of ADHD services.  The guide also includes a list of clinicians providing parent behavior training throughout New England.
“As a clinician working in the field, I know first-hand how difficult it can be for parents and physicians alike to know the latest information about treatment options for children with ADHD,” stated Craig L. Donnelly, MD, Director, Child and Adolescent Psychiatry, Dartmouth-Hitchcock Medical Center.  “The CEPAC Action Guide on ADHD will help primary care providers and parents choose the most appropriate treatment option, while providing important resources for accessing care.”
CEPAC convened in Durham, NH in June to deliberate and vote on the evidence on treatment options for ADHD.  The meeting examined the evidence on treatments for preschoolers, as well as long-term outcomes for children over the age of 6.  The CEPAC Action Guide on ADHD is based on the complete findings of that meeting (see June 26, 2012 news release) and contains resources and action steps for parents, clinicians and insurers.  For parents, the guide contains resources for finding a qualified parent behavior therapist and information on which medications have proven effectiveness in preschool and school-age populations.  For clinicians, several key considerations are suggested when diagnosing and treating preschoolers and school-age children.  In addition, the Action Guide provides examples to payers for formulary placement that could encourage the first-line use of methylphenidate as well as policies that support and encourage more collaboration between primary care providers and psychiatrists.
“As the CEPAC initiative grows and its impact widens, we are striving to find new ways to make the meeting results actionable and applicable to all of the key decision makers in the healthcare system,” stated Steven D. Pearson, MD, MSc, FRCP, President of ICER.  “By developing this Action Guide, we aim to support the overall goal of our healthcare system – to provide patient-centered, high quality care.  This Action Guide translates CEPAC’s work deliberating on critical comparative evidence and value to make that information most useful to parents, clinicians and payers.” 
The number of children diagnosed with attention deficit hyperactivity disorder (ADHD) has risen in recent years, and ADHD is now regarded to be a common condition among children in the United States.  While reported prevalence ranges widely between 6-16% depending on location and measurement technique, it has been estimated that ADHD affects at least 5 million children aged 4-17 years in the U.S.  Over 2.5 times as many boys have a diagnosis of ADHD as girls, and children from lower income families are at nearly double the risk of ADHD relative to those from higher income strata.  CEPAC is the central component of a project funded by the Agency for Healthcare Research and Quality (AHRQ), and directed by ICER, a leading academic comparative effectiveness research group based at the Massachusetts General Hospital’s Institute for Technology Assessment.  
CEPAC is a regional body whose goal is to provide objective, independent guidance on the application of medical evidence to clinical practice and payer policy decisions across New England.  Supported by a federal grant from the Agency for Healthcare Research and Quality (AHRQ), and with backing from a consortium of New England state health policy leaders, CEPAC holds public meetings to consider evidence reviews of medical tests and treatments and provide judgments regarding how the evidence can best be used across New England to improve the quality and value of health care services.  CEPAC consists of practicing physicians with experience in evaluating and using evidence in the practice of healthcare, as well as patient/public members with experience in health policy, patient advocacy and public health.  ICER is managing the day-to-day operations of CEPAC as part of its federally funded initiative meant to develop and test new ways to adapt federal evidence reviews to improve their usefulness for patients, clinicians, and payers.  A list of CEPAC members, and other information about the project, is available online at cepac.icer-review.org.
About ICER
The Institute for Clinical and Economic Review (ICER), based at the Massachusetts General Hospital’s Institute for Technology Assessment (ITA) and an affiliate of Harvard Medical School, provides independent evaluation of the clinical effectiveness and comparative value of new and emerging technologies. Structured as a fully transparent organization, ICER seeks to achieve its ultimate mission of informing public policy and spurring innovation in the use of evidence to improve the value of health care for all.  For more information, please visit www.icer-review.org