Becker's Clinical Quality & Infection Control

28 QUALITY IMPROVEMENT & MEASUREMENT Medical association to create 1st guidelines for diagnosing, treating ADHD By Erica Carbajal T he American Professional Society of ADHD and Related Disorders plans to develop the nation's first guidelines for diagnosing and treating attention-deficit hyperactivity disorder in adults, e Wall Street Journal reported Sept. 1. ere are guidelines for diagnosing and treating the condition in children and adolescents, but none exist for adults. e decision to develop the guidance largely stems from specialists' concerns that telehealth startups Cerebral and Done have overprescribed stimulants throughout the pandemic. In March, the Journal reported that some Cerebral clinicians said they felt pressure to prescribe stimulants, such as Adderall, to patients aer a 30-minute evaluation, which they said was not enough time to properly diagnose ADHD. Large pharmacy retailers including CVS Health and Rite Aid have stopped filling Adderall and other controlled-substance prescriptions for Cerebral and Done. Both companies have previously denied pressuring clinicians to prescribe stimulants. In May, Cerebral said it would stop prescribing most controlled substances. e group working on the new ADHD guidelines told the Journal that research shows many in-person clinicians also don't complete steps necessary for a high-quality evaluation, such as taking blood-pressure readings. "We want to make sure that all ADHD medications are prescribed appropriately and that everyone has access to high-quality evaluations," Ann Childress, MD, president of the American Professional Society of ADHD and Related Disorders, told the news outlet. e guidelines are expected to be released next year and are likely to include steps that would require more than 30 minutes to complete, including obtaining detailed personal and family medical histories. n US life expectancy sees sharpest 2-year decline in 100 years By Erica Carbajal L ife expectancy at birth in the U.S. has fallen to 76.1 years, the lowest it has been since 1996, according to provisional data the CDC published Aug. 31. Average life expectancy has taken a sharp decline since the start of the pandemic. In 2019, life expectancy at birth was about 79 years. That fell to 77 years in 2020, with the latest report suggesting another drop to 76 years. This marks the steepest two-year decline in nearly a century, when life expectancy fell to 57.2 in 1923, The New York Times reported. COVID-19 largely drove the decline seen between 2020 and 2021. Deaths from drug overdoses and other accidental injuries, heart disease and chronic liver disease also contributed. Native Americans and Alaska Natives experienced the largest decline, with life expectancy falling from 67.1 years in 2020 to 65.2 in 2021. In 2019, life expectancy among this group was 71.8 years, meaning it has since fallen 6.6 years. "Even small declines in life expectancy of a tenth or two- tenths of a year mean that on a population level, a lot more people are dying prematurely than they really should be," Robert Anderson, PhD, chief of mortality statistics at the CDC's National Center for Health Statistics, told the Times. n Healthcare-associated infections hit smaller community hospitals hardest during pandemic, study finds By Cailey Gleeson S maller community hospitals have been most affected by the COVID-19-related uptick in healthcare- associated infections, a study published Aug. 23 in Clinical Infectious Diseases found. Researchers analyzed 53 hospitals in the Southeastern U.S. for reports of central line-associated bloodstream infections, catheter-associated urinary tract infections, Clostridioides difficile infections and ventilator-associated events from Jan. 1, 2018, to March 31, 2021. Three key findings: • CLABSIs and VAEs increased by 24 percent and 34 percent, respectively, during the pandemic. • CDIs increased by 4.2 percent per month during the pandemic. • CAUTIs did not change significantly during the pandemic across all hospital types. n

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