Pharmacists play a crucial role in the management of ADHD, encompassing a wide range of responsibilities that extend beyond dispensing medications.

Attention deficit hyperactivity disorder (ADHD) is characterised by inattention, hyperactivity, and impulsivity. While the exact causes remain unknown, it is believed to be influenced by genetic, environmental, and neurobiological factors.¹ Even though ADHD can require varied degrees of diagnostic testing, pharmacists may be among the first medical practitioners to learn about a patient's symptoms. This is due in part to the fact that pharmacists see patients more often than other medical professionals.⁶

Key Aspects

1. Medication Management and Optimisation

Pharmacists are responsible for ensuring the safe and effective use of ADHD medications. This includes:

• Dispense medications accurately ensuring patients understand their dosing schedules.²
• Review medication regimens for potential drug interactions, contraindications, and side effects.²
• Optimise medication regimens in collaboration with physicians, which may involve adjusting dosages or switching medications based on patient response and side effects.²
• Elnaem et al. caution that “a pharmacist must recognise how stimulants influence appetite and growth in children with ADHD. Children using stimulants should have their height and weight assessed regularly, such as semi-annually.”²

2. Patient Education and Counselling

• Educate patients and caregivers about ADHD and its treatment, including the importance of adherence to medication and the potential side effects.^2,3
• Address misconceptions about ADHD medications, such as fears about addiction or stigmatisation.^2,3
• Counsel on lifestyle modifications and non-pharmacological interventions that can support medication therapy, such as dietary changes, exercise, and behavioural strategies.²

3. Monitoring and Follow-Up

• Conduct follow-up consultations to assess treatment outcomes and patient satisfaction.² “It is important for pharmacists to check blood pressure and heart rate at follow-up sessions,” advised Elnaem et al.
• Adjust treatment plans in collaboration with the healthcare team based on patient feedback and clinical outcomes.^2,3
• Ensure adherence to medication through various strategies, including reminder systems or simplifying medication regimens.²

4. Collaboration with Healthcare Team

• Communicate with other healthcare providers to share insights on the patient’s progress and any concerns related to medication therapy.²
• Participate in case conferences or team meetings to discuss complex cases and contribute to the development of comprehensive care plans.²

5. Advocacy and Support

• Provide support and reassurance to patients and families navigating the challenges of ADHD.^2,3
• Help to navigate insurance coverage and access to medications, including finding cost-effective treatment options.²
• Promote awareness about ADHD and reducing stigma associated with the condition and its treatment.²

6. Utilisation of Technology

• Offer remote consultations and support for patients who may have difficulty accessing traditional healthcare services.²
• Leverage digital health applications to monitor patient adherence, side effects, and overall well-being.²

Pharmacists’ involvement is integral to the comprehensive care of patients with ADHD, contributing significantly to medication management, patient education, monitoring side effects, and overall support.²

References

1. 1. Wong, R.S.Y. Psychopathology of attention deficit/hyperactivity disorder: from an inflammatory perspective. Egypt J Neurol Psychiatry Neurosurg 58, 123 (2022). Available from: https://doi.org/10.1186/s41983-022-00561-y.
   2. Elnaem MH, AbouKhatwa MM, Elrggal ME, Dehele IS. Attention Deficit Hyperactivity Disorder: What Are Pharmacists' Roles and Associated Outcomes? Int J Environ Res Public Health. 2023 Feb 3;20(3):2754. doi: 10.3390/ijerph20032754. PMID: 36768120; PMCID: PMC9916014. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9916014/.
   3. Bulloch M. ADHD Awareness Month and the Pharmacist’s Role. Pharmacy Times. 5 October 2021. Available from: https://www.pharmacytimes.com/view/adhd-awareness-month-and-the-pharmacist-s-role.