Telehealth's remote monitoring programme addresses national ADHD medication supply issue

Mersey Care's Telehealth team has enjoyed impressive results after setting up an ADHD pathway within two weeks to address a national ADHD medication supply issue.

During a national problem with supply shortages of ADHD related medication in October 2023, the ADHD service were concerned they had no visibility of how much medication patients in their care had remaining, nor did they have any visibility of how this was affecting them.   

It prompted the Telehealth team to rapidly implement remote monitoring to provide support for ADHD patients. Working with Docobo, who supply the technology for Telehealth, the team co-designed a bespoke question set for patients and sent a text message encouraging them to download an app so they can establish care plans.

They were able to rapidly welcome 219 patients into the system, otherwise known as 'onboarding', while providing advice and support while also capturing the visibility of supplies and side effects. It helped reduce the workload for the ADHD service and better outcomes for patients at a challenging time.

How were patients onboarded? 

• ADHD service sends caseload to Telehealth
• Telehealth text (SMS) patient to offer support
• Patient ‘opts in’ and is onboarded to Telehealth
• Patient downloads Telehealth App and completes enrolment
• Monitoring by Telehealth commences
• Care plan is identified if the patient has one with GP

What data was collected from the patient?

• Current medication, dosage and any symptoms identified from not taking the medicine
• How much supply the patient had left
• Any action already taken due to medication shortage
• Any clinical harm due to medication shortage

Results of the Telehealth approach

The bespoke ADHD question set helped identify how much medication patients had left and whether they were experiencing any issues resulting from low or no medication. The Telehealth team were able to provide clinical advice for patients and escalate to the ADHD service or GP as required.  

Patients were divided into ‘amber’ or ‘red’ based on clinical need. Depending on their symptoms, most amber patients were called by the Telehealth team, while every red alert patient was also called. The average call length for both was 10 minutes.

Peter Almond, Telehealth Head of Service at Mersey Care, said: “By using Telehealth we were able to rapidly deploy a solution to gather vital patient information which we could use to better support them during this worrying period.”

• 219 ADHD patients have been onboarded to date
• 177 patients live on Telehealth ADHD caseload
• 629 patients offered service to date via SMS
• 550 SMS delivered successfully
• 235 patients responded to SMS = 43 percent response rate

What Telehealth helped ADHD team to find out

• 28 percent of patients had run out of medication with 39 percent having fewer than 14 days' supply remaining
• 26 percent of patients experiencing sleep issues
• 54 percent diet affected
• 13 percent signs of mood disturbance
• 28 percent daily activities affected.

Benefits of telehealth approach

“The rapid roll out enabled the team to proactively communicate with patients to advise on the medication shortage," added Mr Almond. "We were also able to provide clinical advice and signpost to relevant services, as well as giving general advice and submitting symptoms.  

"This has resulted in a reduction of workload for ADHD services: to date, red alert patients supported by Telehealth account to around 35+ days' worth of time managed.”

Telehealth continues to work with the ADHD service and is exploring future pathways.