ADHD treatment plan

Diagnosis: [diagnosis (with ICD-10 reference if available) (Only include if explicitly mentioned in the transcript, contextual notes or clinical note; otherwise omit completely.)] Medication: [list medications, dosage, frequency (Only include if explicitly mentioned in the transcript, contextual notes or clinical note; otherwise omit completely.)] Physical parameters: [State date of reading if available and list heart rate in bpm, BP in mmHg. (Only include if explicitly mentioned in the transcript, contextual notes or clinical note; otherwise omit completely.)] [State current weight in kg if available (Only include if explicitly mentioned in the transcript, contextual notes or clinical note; otherwise omit completely.)] Care Plan: 1. [(If no heart rate provided or if advised to send please state "[Patient name] will send in [his / her / their] baseline heart rate. If no BP provided or if advised to send please state "[Patient name] will send in [his / her / their] baseline BP.] [If weight has not already been provided or if advised to send please state "[Patient name] will send in [his / her / their] pre-treatment weight] (Only include if explicitly mentioned in the transcript, contextual notes or clinical note; otherwise omit completely.)] 2. Titration regime to start as follows: Week [state week 1 or 1-2 depending on advice (Only include if explicitly mentioned in the transcript, contextual notes or clinical note; otherwise omit completely.)]: [drug name (either Methylphenidate or lisdexamfetamine) (dose in mg) (frequency) (Only include if explicitly mentioned in the transcript, contextual notes or clinical note; otherwise omit completely.)] Week [state week 2 or 3-4 depending on advice (Only include if explicitly mentioned in the transcript, contextual notes or clinical note; otherwise omit completely.)]: [drug name (either Methylphenidate or lisdexamfetamine) (dose in mg) (frequency) (Only include if explicitly mentioned in the transcript, contextual notes or clinical note; otherwise omit completely.)] Prescription [state "given to patient" for in person appointment or "via Pharmacierge" for video appointments (Only include if explicitly mentioned in the transcript, contextual notes or clinical note; otherwise omit completely.)] 3. We will meet to review this [(in [number of weeks until review] weeks' time or on [date]) but [Patient name] can bring this forward if [he / she / they] has / have any concerns. (Only include if explicitly mentioned in the transcript, contextual notes or clinical note; otherwise omit completely.)] 4. (If university is mentioned state ",I will send [Patient name] a supporting letter for university" (Only include if explicitly mentioned in the transcript, contextual notes or clinical note; otherwise omit completely.)) 5. (If discussed state "I will share information on [medication / serotonin syndrome / ADHD resources"] (Only include if explicitly mentioned in the transcript, contextual notes or clinical note; otherwise omit completely.)) We will always do our best to bring appointments forward if our patients are struggling and need support. As [Healthcare Provider] is not an emergency service, in a crisis the following support lines are available: NHS Sussex Mental Health Line on 0800 0309 500 or via 111 Samaritans 116 123 (free from any phone), email jo@samaritans.org, SANEline. If you're experiencing a mental health problem or supporting someone else, you can call SANEline on 0300 304 7000 (4.30pm–10.30pm every day). National Suicide Prevention Helpline UK. Offers a supportive listening service to anyone with thoughts of suicide 0800 689 5652 (6pm to midnight every day). Campaign Against Living Miserably (CALM). You can call the CALM on 0800 58 58 58 (5pm–midnight every day) if you are struggling and need to talk. Shout. If you would prefer not to talk but want some mental health support, you could text SHOUT to 85258. Shout offers a confidential 24/7 text service providing support if you are in crisis and need immediate help. In a severe emergency, use 999 or visit the Accident and Emergency department at your local hospital. Review: It was a pleasure to meet with [Patient name] [either use "at [Healthcare Provider]" if appointment was in person or "via video link" if was online] on [today's date]. [His / Her / Their] DIVA-5 assessment has confirmed the diagnosis of ADHD (combined) with [Patient name] scoring highly in both the inattentive [?/9 features] and hyperactive [?/9 features] domains. [Add any specific patient concerns here including feelings on diagnosis, hopes for treatment outcome (Only include if explicitly mentioned in the transcript, contextual notes or clinical note; otherwise omit completely.)] [Add any specific discussion of mood or pre-existing mental health difficulties here (Only include if explicitly mentioned in the transcript, contextual notes or clinical note; otherwise omit completely.)] [Add relevant medical history or specific medical discussion here including OCD, tics, blood pressure, heart disease, palpitations, seizures or epilepsy (Only include if explicitly mentioned in the transcript, contextual notes or clinical note; otherwise omit completely.)] We discussed treatment options. It's important to remember that non-pharmacological strategies such as coaching and exercise are important tools in managing ADHD, as well as the stimulant and non-stimulant medications options. Exercise in particular can be very useful for managing some of the features of ADHD. However, it can be helpful to trial medication before looking to implement supporting strategies. We discussed the limitations of stimulants, in particular their limited efficacy aspects such as time blindness but they do help with the ability to get started on tasks, to stay focused and on track, and the ability to retain awareness of outstanding jobs, as well as reducing anxiety and easing some of the emotional reactivity that is often associated with ADHD. [Patient name] would like to try medication and we will begin with a trial of the stimulant lisdexamfetamine. We discussed the side effects to watch out for (headaches, appetite suppression and weight loss, potential sleep disturbance, palpitations and a raised blood pressure). I explained about the risk of a lowering of mood and that these medications can sometimes precipitate mania or psychosis. [Patient name] should keep an eye for any mood changes, especially any thoughts of not wanting to be here, and stop the medication and let me know if [he / she / they] has / have any concerns. Some options for accessing support out of hours are listed above. We discussed following a high-protein diet to reduce the chance of experiencing anxiety or palpitations and I recommended having breakfast before taking the medication. I would advise [Patient name] to avoid caffeine, alcohol and recreational drugs as these can increase the risk of anxiety and palpitations when taking stimulants. [Add discussion about interactions with other medications and additional aspects to monitor such as serotonin syndrome here. If taking no other medications state "[Patient name] is not taking any other medications that might interact with the [list stimulant medication to be started]" (Only include if explicitly mentioned in the transcript, contextual notes or clinical note; otherwise omit completely.)] (If patient is a woman state "We discussed the risks associated with these medications in pregnancy and contraception and prenatal planning" (Only include if explicitly mentioned in the transcript, contextual notes or clinical note; otherwise omit completely.)) (If patient is a woman state "I would also recommend to [Patient name] in the future that she discuss and plans for pregnancy with her doctor as, while care for the mother and the developing child in pregnancy is always a balance of risks, stimulants are best avoided if possible, certainly in the first trimester and prenatal planning is advised." (Only include if explicitly mentioned in the transcript, contextual notes or clinical note; otherwise omit completely.)) [Patient name] only needs to inform the DVLA if [he / she / they] feels the medication or condition is affecting [his / her / their] ability to drive safely. [His / Her / Their] mental state was unchanged with good engagement, spontaneous articulate speech and a reactive affect. [Patient name] felt okay in [his / her / their] mood [Add any discussion of mood / suicide / hopelessness / self-harm here (Only include if explicitly mentioned in the transcript, contextual notes or clinical note; otherwise omit completely.)]. There were no new affective or psychotic symptoms. [His / Her / Their] capacity to make decisions about [his / her / their] care and treatment was intact. (For each section, only include if explicitly mentioned in transcript or context, else omit section entirely. Never come up with your own patient details, assessment, plan, interventions, evaluation, or next steps—use only the transcript, contextual notes, or clinical note as reference for all information. If any information related to a placeholder has not been explicitly mentioned, do not state that in the output; simply leave the relevant placeholder or section out entirely. Use as many lines, paragraphs, or bullet points as needed to capture all relevant information from the transcript.)