Clinical perspectives on the identification of neurodevelopmental conditions in children and changes in referral pathways: qualitative interviews.
Child & adolescent psychiatry
Community child health
Developmental neurology & neurodisability
PRIMARY CARE
QUALITATIVE RESEARCH
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
13 04 2022
13 04 2022
Historique:
entrez:
14
4
2022
pubmed:
15
4
2022
medline:
16
4
2022
Statut:
epublish
Résumé
Previous work has raised questions about the role of general practitioners (GPs) in the identification of neurodevelopmental conditions such as autism spectrum disorders (autism) and attention deficit hyperactivity disorders (ADHD). This study aimed to explore how GPs identify these conditions in practice and their perspectives on recent changes to local referral pathways that mean referrals to the neurodevelopmental team come through educational professionals and health visitors, rather than GPs. This study also aimed to explore Child and Adolescent Mental Health Services (CAMHS) specialist's perspectives on the role of GPs. GP practices, local neurodevelopmental services and specialist CAMHS services in the UK. semistructured interviews were conducted with GPs (n=8), specialists in local CAMHS (n=7), and professionals at national CAMHS services around the country (n=10). Interviews were conducted between January and May 2019. A framework approach informed by thematic analysis was used to analyse the data. GPs drew on various forms of tacit and explicit information including behavioural markers, parental report, prior knowledge of the family, expert and lay resources. Opinions varied between GPs regarding changes to the referral pathway, with some accepting the changes and others describing it as a 'disaster'. CAMHS specialists tended to feel that GPs required more neurodevelopmental training and time to conduct consultations. This study adds to the literature showing that GPs use an array of information sources when making referral decisions for autism and ADHD. Further work is urgently required to evaluate the impact of reconfiguring neurodevelopmental referral pathways such that GPs have a diminished role in identification.
Identifiants
pubmed: 35418420
pii: bmjopen-2021-049821
doi: 10.1136/bmjopen-2021-049821
pmc: PMC9014038
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e049821Subventions
Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : Department of Health
Pays : United Kingdom
Informations de copyright
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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