Roles and impacts of pharmacists in attention-deficit hyperactivity disorder services: a scoping review.

INTRODUCTION

Demand for attention-deficit hyperactivity disorder (ADHD) services has increased substantially across health systems, placing pressure on specialist services and contributing to prolonged waiting times and inconsistent medication monitoring. Pharmacists have established expertise in medicines optimisation and, in some settings, are authorised to prescribe. Yet their role within ADHD care pathways remains poorly characterised.Kindly check and confirm the inserted city name in affiliations 3, 5, 6 and country name in affiliation 6 are correct and amend if necessary.Changes have been made, where necessary.   AIM: This scoping review aims to map the existing empirical evidence on pharmacist involvement in ADHD services, synthesise reported roles and impacts, and identify key evidence gaps to inform future research and service development.

METHOD: A scoping review was conducted in accordance with the Arksey and O'Malley framework and reported using PRISMA-ScR guidance. Six databases (PubMed, PsycINFO, Embase, CINAHL, Scopus, and Web of Science) were searched from inception to December 2025. Empirical studies evaluating implemented pharmacist involvement in ADHD services were included, irrespective of study design. Data were charted and synthesised narratively across domains relating to clinical care, service delivery, economic outcomes, and barriers to implementation.

RESULTS

Thirteen studies were included, published between 2008 and 2025, primarily from the United States and the United Kingdom. Most were service evaluations or pre-post studies, with one randomised trial. Pharmacists were involved in a broad range of activities, including medication initiation, titration, monitoring, follow-up, patient education, and service governance, often as independent prescribers or within collaborative multidisciplinary models. Reported impacts included improved adherence to recommended monitoring standards, increased service capacity, reduced waiting times, and more efficient workforce utilisation, with some evidence of potential cost savings. However, outcome measures varied widely, and patient-reported outcomes, comparative effectiveness, and implementation processes were inconsistently examined.

CONCLUSION

This review identifies a small but expanding evidence base indicating potential roles for pharmacists in ADHD services, particularly in medicines management and service delivery. However, the absence of clearly defined service models and limited comparative and implementation-focused evidence constrain wider adoption across health systems. Further research is needed to inform scalable and sustainable approaches to pharmacist integration in ADHD care.