Advice on COVID-19

Advice to health and social care professionals regarding management of ADHD during the COVID-19 crisis.

People with ADHD and their carers may find current rules and restrictions necessary to tackle the COVID-19 threat particularly challenging. For many it will be difficult, particularly if they are highly symptomatic.

In supporting people with ADHD during this period, we believe the following guidance applies:

• Assessments for ADHD can continue to take place using online video technology provided the quality of the information collected is consistent with NICE NG87 (2018) and the patient feels that they have a private place to take the video call (for more details see APA and RCPSych PIPSIG telepsychiatry guidelines: www.rcpsych.ac.uk/docs/default-source/members/sigs/private-and-independent-practice-pipsig/pipsig-telepsychiatry-guidelines-revised-mar16.pdf )
• People with ADHD should continue with their medication as usual.

Failure to maintain established medication will increase health risks from COVID-19 infection to patients, their families and members of the public if behaviour related to ADHD becomes more erratic, disorganised and poorly controlled, impacting on requirements for social isolation and distancing.

• Routine cardiovascular assessments and monitoring for people with ADHD without any cardiovascular risk factors could be postponed until after the COVID-19 crisis, as currently, the risks from face to face C/V assessments with these patients outweigh the benefits of cardiac monitoring.

We recommend home monitoring of blood pressure, pulse and weight whenever possible using home Blood Pressure machines (see note 1).

• People with ADHD may find working from home (WFH) during the COVID-19 pandemic especially challenging and anxiety-provoking. We recommend adjusted ADHD coaching and signposting to webpages of ADHD support organisations and user groups (e.g. https://www.additudemag.com/working-from-home-adhd )
• If people feel they have the COVID-19, they do not need to stop taking ADHD medication unless they have severe symptoms (e.g. affecting blood pressure, pulse or breathing).

If you have any comments or additions please contact info@ukaan.org

Note 1: Advise on home monitoring

Patients could be encouraged to purchase a home Blood Pressure machine and guided through using it including:

• Taking the BP a few days after starting a new drug / dose
• Taking the BP at least 2 hours after taking a dose
• Sitting down for 10-15 minutes before taking the reading
• Taking the reading on the left arm
• Taking the lowest of 3 readings
• At the same time capturing the pulse

Readings can then be communicated to the clinic, and advice on next steps can then be provided by the clinician.

Guidance recommended from the European ADHD Guidelines Group printed in The Lancet

Addendum The Lancet CAH Online - Free Access

https://pubmed.ncbi.nlm.nih.gov/32697120/

An Israeli study showing that untreated ADHD is a risk for coronavirus infection.

https://www.bmj.com/content/370/bmj.m2752/rr-5

Covid-19: an opportunity to reduce unnecessary healthcare