Date of Award

Spring 5-31-2026

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Autumn Roque, DNP, APRN, PMHNP- BC

Abstract

Objective: To evaluate whether an APRN-led pilot Adult ADHD Diagnostic Clinic within a large academic healthcare system in the San Diego area improves timely access to diagnostic evaluation and optimizes care disposition for adults with suspected ADHD.

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is characterized by inattention and/or hyperactivity-impulsivity that interferes with functioning in daily life. It often emerges in childhood and persists into adulthood, affecting approximately 360 million adults globally. Despite its prevalence and associated functional and psychiatric burden, adult ADHD remains underdiagnosed and undertreated due to limited primary care training, stigma, and reduced access to psychiatric services, resulting in delayed evaluations and inconsistent care pathways.

Methods: A retrospective chart review was conducted over a 60-day period in a pilot Adult ADHD Diagnostic Clinic to evaluate patient volume, diagnostic outcomes, and disposition patterns, including return to primary care and referral to general psychiatry.

Results: A total of 40 patients completed ADHD evaluations during the 60-day period. Seventeen patients (42.5%) met diagnostic criteria for ADHD, while 23 (57.5%) received an alternative diagnosis. Most patients (62.5%) were returned to primary care for management, while 22.5% required referral to general psychiatry and 15% were directed to other services.

Conclusion: The APRN-led Adult Diagnostic Clinic demonstrates a feasible approach to improving access to timely ADHD evaluation. Patients presented with diverse psychiatric needs, highlighting the importance of structured diagnostic assessment. Most patients were appropriately managed in primary care, supporting more efficient use of specialty psychiatric services.

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