ADHD diagnosis and management are increasingly part of general practice. This issue offers Focus guidance plus clinical, research and professional pieces for the desk. 17 pieces summarised. Source TOC: RACGP September 2026.
Editorial#1
Guest editorial: Attention deficit hyperactivity disorder has come of age
John Kramer OAM
This guest editorial frames ADHD as finally ‘coming of age’ in Australian general practice in the mid-2020s, with rising recognition across a wide phenotypic spectrum rather than a sudden epidemic of new disease. Kramer traces the local history from early consumer advocacy and state GP prescribing pilots through AADPA guidelines, the Senate inquiry, the 2025 RACGP position statement, and 2026 jurisdictional reforms enabling more GP-led care. The piece argues genetics and under-recognition explain much of the apparent incidence rise, and that GPs are central to multimodal assessment and ongoing care. Useful desk context for why ADHD Focus content is arriving now and how policy is shifting prescribing responsibility toward primary care.
Non-pharmacological strategies in the management of attention deficit hyperactivity disorder
Ewa Nowinska, Stacey V Savage
Practical overview of evidence-based non-drug ADHD supports that sit alongside medication in GP care. Emphasises multimodal management: CBT and behavioural parent training for executive function, emotion regulation and coping; school-based and organisational scaffolds; and lifestyle levers (sleep, exercise, routine). Framed for busy general practice—what to recommend, who to involve, and how non-pharmacological work remains essential even when stimulants help. Handy when counselling newly diagnosed patients or those preferring a stepped, function-first approach.
Summary based on abstract / freely available excerpt (full text may be member-gated).
Professional#3
Balancing care with compliance: Medicolegal issues for general practitioners treating attention deficit hyperactivity disorder
Owen Bradfield, Dileni Fernando
As states relax S8 psychostimulant rules, GPs face rising medicolegal exposure around ADHD assessment, initiation, monitoring and shared care. The article stresses compliance with jurisdiction-specific prescribing law and PBS requirements, careful assessment, clear risk counselling (misuse/dependence), and documentation. Telehealth prescribing is flagged as higher risk where examination and identity verification are limited. Useful checklist mindset before expanding ADHD prescribing: consent (including separated parents), monitoring, and knowing when not to prescribe alone.
Summary based on abstract / freely available excerpt (full text may be member-gated).
Research#4
New model of management of attention deficit hyperactivity disorder by trained general practitioners: Prospective cohort study in 207 children
Alison Poulton, Jessica Bedford, Simone Heiler, Lakshmi Gribble, Lujing Lena Liu, Sviatlana Kamarova, Pippa Oakeshott, Marilyn Dyson, Habib Bhurawala
Prospective cohort from Nepean Blue Mountains LHD describing the first 207 children (mean age 11; 112 boys, 91 girls, 4 non-binary) diagnosed 2023–26 by four GPs trained in ADHD care across two practices. Most referrals (57%) came from other GPs; median wait to first appointment was only 3 weeks—much shorter than typical specialist queues. Reports medication stabilisation outcomes under an integrated GP-led model. Supports the policy case that upskilled GPs can safely expand paediatric ADHD capacity if training and pathways are in place.
Summary based on abstract / freely available excerpt (full text may be member-gated).
Professional#5
Medication initiation and optimisation in attention deficit hyperactivity disorder: A practical approach for general practice
Katarzyna Tognarini, Hoie Kidd Leong, Vicki Nahamkes, John Kramer OAM, Will Errington
Hands-on guide for Australian GPs initiating stimulant or non-stimulant ADHD medicines within evolving shared-care models. Stresses medication as one part of multimodal care with psychoeducation and psychosocial supports, titrated over multiple visits using shared decision-making and functional goals—not symptom scores alone. Covers side-effect surveillance, when to escalate to specialists, and that response varies between patients. Clinic-ready framing for first scripts, dose optimisation, and follow-up structure.
Summary based on abstract / freely available excerpt (full text may be member-gated).
AJGP for your CPD#6
September 2026 Clinical challenge
AJGP CPD
CPD companion built on this issue’s ADHD Focus articles: multiple-choice and short-answer items covering medicolegal pitfalls, stimulant monitoring, non-stimulant PBS limits, consent conflicts, and interpreting the Poulton GP-led cohort. Completing the Clinical challenge via gplearning records 8 CPD hours (EA/RP split) automatically to myCPD Home; self-directed reading and Measuring Outcomes QI options are also outlined. Ideal for logging September Focus learning against real clinic scenarios (adult IR methylphenidate wear-off, paediatric consent disputes, regional initiation).
Letters section featuring correspondence on practice-relevant gaps. One highlighted letter argues hidradenitis suppurativa is under-represented in the RACGP dermatology curriculum (listed once under ‘disorders of sweating’) despite 1–4% prevalence and long diagnostic delay, and calls for dedicated learning outcomes, staging, first-line care and psychosocial content. Reminds GPs that curriculum gaps can mirror under-recognition in the consulting room—worth a quick read when updating practice education priorities.
Review of Lp(a) as a largely genetic, under-recognised driver of ASCVD and aortic stenosis, elevated in ~20% of people. Advises measuring Lp(a) especially in premature, familial, severe or progressive ASCVD/valve disease; some international guidelines now favour once-in-a-lifetime testing in all adults. No specific Lp(a)-lowering drugs are yet available, so management focuses on aggressive conventional risk reduction while awaiting therapies. Practical takeaway: order Lp(a) in high-risk patients now and intensify LDL/lifestyle/secondary prevention when it is raised.
Summary based on abstract / freely available excerpt (full text may be member-gated).
Clinical#9
Management of patients using anabolic androgenic steroids and other performance and image enhancing drugs (including peptides): A harm reduction approach
Beng Eu, Esther Han, Kevin Lee, Eva Jackson, Katinka van de Ven
GP-focused harm-reduction guide for patients using AAS and other PIEDs (including peptides), now seen well beyond elite sport via informal and online markets. Stresses non-judgemental enquiry—stigma and confidentiality fears silence disclosure—and practical monitoring of cardiovascular, endocrine, hepatic, fertility and mental-health risks. Outlines engagement and risk-mitigation strategies rather than abstinence-only messaging. Useful when gym-going adults present with polycythaemia, hypogonadism, acne, mood change or unexplained LFT/lipid shifts.
Summary based on abstract / freely available excerpt (full text may be member-gated).
Clinical#10
A guide to the 3-year-old health check for general practice
Tim Jones, Marita Jones, Aaron Chambers, Harriet Hiscock
Outlines how to deliver the Medicare-funded 3-year-old health check arriving November 2026 under Thriving Kids, using a case-based health-assessment framework. Notes that by age three more than one in five children have at least one developmental vulnerability, making this a high-yield early-intervention window. Leverages continuity of GP–family relationship for development, wellbeing, education, supports and timely referral within community context. Prep reading before the item lands—structure the consult beyond a tick-box growth check.
Summary based on abstract / freely available excerpt (full text may be member-gated).
Clinical#11
Methamphetamine-associated cardiovascular conditions in general practice: Screening, management and harm reduction
Cliff Deyo, Sarah Garry, Thileepan Naren, Owen Harris, Casey Grover, Esther Han, David Corbet, Elizabeth Paratz
Expert/evidence guidance on methamphetamine-associated cardiovascular conditions (MACCs)—an under-recognised cause of acute and chronic heart disease. Australian MACC deaths rose seven-fold 2009–2020 and were the leading natural cause of death among people who use methamphetamine; early abstinence plus medical care improves prognosis, so screening matters. Addresses stigma, unfamiliarity and lack of guidelines that currently suppress screening. Clinic pearl: maintain high suspicion and systematically screen/manage CV risk in patients who use methamphetamine, with harm-reduction framing.
Summary based on abstract / freely available excerpt (full text may be member-gated).
Case study#12
Scaly hyperpigmented patches on a patient with skin of colour
Senhong Lee, Michelle Rodrigues
Case of a 55-year-old man with Fitzpatrick VI skin and slowly progressive asymptomatic hyperpigmented scaly patches on the upper back—favoured diagnosis pityriasis versicolor. Differentials discussed include confluent and reticulated papillomatosis, patch-stage mycosis fungoides, seborrhoeic dermatitis, pityriasis rosea and erythrasma (plus pityriasis alba/vitiligo for hypopigmented variants). Covers clinical diagnosis tips and initial confirmatory investigations. Excellent refresher for recognising PV morphology on richly pigmented skin where erythema cues are subtler.
‘The answer is simple: be respectful’: Female general practitioner views on reducing weight stigma to improve maternity care
Jessica van den Heuvel, Katharine Wallis, Lauren Kearney, Leonie Callaway
Qualitative study of Australian maternity-care GPs scoring high on fat-acceptance measures (20 interviews, 2024). Participants described personal and professional experiences of weight stigma and used reflective practice to reduce bias when caring for larger-bodied pregnant women. Organisational recommendations include revising guidelines, communication-skills training, and funding structures that enable respectful, non-stigmatising antenatal care. Actionable for shared antenatal clinics: lead with respect, fix system cues, and avoid weight-first framing that deters engagement.
Summary based on abstract / freely available excerpt (full text may be member-gated).
Research#14
Health-related notifications about GPs: Descriptive analysis of 10 years of data from the Australian Health Practitioner Regulation Agency
Dilanka Hettiarachchi, Yamna Taouk, Matthew Spittal, Anu Tayal, Owen Bradfield, Martin Fletcher, Marie Bismark
Linked 10 years of Ahpra notifications with workforce demographics. GPs accounted for 40% of doctor notifications 2012–2022; health-impairment matters were only 2.8%, most often drug/alcohol concerns in male and rural GPs, with mental health also prominent. Aims to inform wellbeing supports while protecting patients. Takeaway for practice leaders: impairment notifications are uncommon but patterned—early pastoral support, rural workload design and confidential help pathways matter as much as compliance culture.
Non-technical primer on clinical AI with emphasis on large language models, demystifying generative AI, machine learning and NLP jargon that blocks adoption. Key caution: fluent text creates an illusion of semantic understanding that current systems do not truly have—knowing this prevents unsafe over-trust. Positions AI as potentially revolutionary yet still not ‘intelligent’ in the everyday sense. Good starter for clinic AI policy conversations and safe scribe/tool use; first in an AJGP AI series.
Summary based on abstract / freely available excerpt (full text may be member-gated).
Professional#16
General practitioner burnout: A practical model to identify solutions
Shaun Prentice, Jill Benson, Margaret Kay
Practical model integrating meaningfulness research with the Job Demands–Resources framework to redesign everyday GP tasks. Each task has demands costing energy, modulated by external supports and the GP’s psychosocial context; alignment with personal values increases reward. Whether a task sustains or drains wellbeing depends on demand–reward balance. Clinic use: audit inbox, consult types and admin for value-alignment and resource gaps rather than treating burnout as individual failure alone.
Summary based on abstract / freely available excerpt (full text may be member-gated).
Beyond the clinic door#17
It was a long weekend
Hubert van Doorn
Reflective narrative from a rural GP who pushed through headache and cognitive fog early in the COVID era—worried about vaccine-related thrombosis—until mid-consult language and action suddenly failed during a straightforward gout presentation. A colleague took over; he went home facing the tension between duty, short-staffing and recognising personal illness. Reminds clinicians that insight can fail under load and that asking for help mid-session is professional, not weak. Short CPD-adjacent reading on self-care and knowing when to stop.