Monitoring of metabolic side-effects in children and adolescents prescribed antipsychotic medication: A systematic review

2021 ◽  
pp. 000486742110096
Author(s):  
Laura Mead ◽  
Alice Ayres ◽  
Julie A Blake ◽  
James G Scott
Keyword(s):  
Clinical Practice ◽  
Side Effects ◽  
Children And Adolescents ◽  
Systematic Reviews ◽  
Antipsychotic Medication ◽  
Biochemical Parameters ◽  
Cochrane Library ◽  
Cochrane Central Register ◽  
Metabolic Monitoring ◽  
Metabolic Side Effects

Objectives: Prescribing antipsychotic medications to children and adolescents with severe mental and developmental disorders is common; however, there is a lack of consensus on appropriate metabolic monitoring for this population. This review systematically evaluates studies examining metabolic monitoring of children and adolescents prescribed antipsychotic medication to understand the clinical practice of metabolic monitoring and identify opportunities to improve the safety of antipsychotic prescribing in this population. Methods: A systematic search for original research on metabolic monitoring in children and adolescents prescribed antipsychotics was conducted in six databases (PubMed, EMBASE, PsycINFO, The Cochrane Library [Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, CENTRAL], Cochrane Methodology Register and Web of Science [Science and Social Science Citation Index]) from inception to February 2020 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were assessed for quality and findings summarised using narrative synthesis. Results: Fifteen papers were identified. Studies agreed on the need for metabolic monitoring; however, there was a gap between guideline-recommended practice and clinical practice. Variable rates of baseline and subsequent monitoring were reported for both physical and biochemical parameters, with particularly low rates for monitoring requiring venesection. Younger age was also associated with lower monitoring rates. Implementation of quality improvement activities (new guidelines, staff education and checklists) improved monitoring rates although the measurement of biochemical parameters still occurred in only a minority of children. Conclusion: Despite widespread awareness and concern regarding metabolic side-effects, monitoring occurred inconsistently and infrequently, particularly for biochemical parameters requiring venesection. Monitoring of anthropometric measures (weight, body mass index and waist circumference) with escalation to more laboratory testing where metabolic concerns are identified may improve monitoring. Minimising iatrogenic harm, through reduced antipsychotic prescription where possible, is a clinical priority in this population.

scholarly journals Active Video Games for Improving Mental Health and Physical Fitness—An Alternative for Children and Adolescents during Social Isolation: An Overview

2021 ◽  
Vol 18 (4) ◽  
pp. 1641 ◽  
Author(s):  
Isis Kelly dos Santos ◽  
Rafaela Catherine da Silva Cunha de Medeiros ◽  
Jason Azevedo de Medeiros ◽  
Paulo Francisco de Almeida-Neto ◽  
Dianne Cristina Souza de Sena ◽  
...  
Keyword(s):  
Mental Health ◽  
Video Games ◽  
Physical Fitness ◽  
Children And Adolescents ◽  
Social Isolation ◽  
Systematic Reviews ◽  
Cochrane Library ◽  
Active Video Games ◽  
Moderate Quality ◽  
Active Video

The aim of this study was to synthesize the evidence on the effects of active video games (AVGs) on mental health, physical fitness and body composition of children and adolescents. A search was conducted in the following databases: PubMed; MEDLINE (by Ovid); SportDiscus, Cochrane library systematic reviews (CENTRAL) and EMBASE with no language restrictions during October 2020. Reviews on the use of AVGs were included in the study. We use the AMSTAR (A MeaSurement Tool to Assess systematic Reviews) scale to analyze the methodological quality of the studies. Seventeen systematic reviews and meta-analyzes were included on the effects of AVGs with 30 to 4728 children and adolescents of both sexes with ages ranging from 6 to 19 years. In five studies, the population was overweight or obese. Regarding the quality, 12 studies were of moderate quality, two had high quality, two had low quality and one showed very low quality. The analyzed data indicate that the use of AVGs with a frequency of 1 to 3 times a week with durations of between 10 and 90 min per day shows positive effects on mental health and physical functioning. There was moderate quality evidence that AVGs can result in benefits for self-esteem, increased energy expenditure, physical activity and reduced body mass index in children and adolescents who used AVGs in the home environment. Further research is needed on this tool to help in the process of social isolation and consequently in promoting health and well-being.

scholarly journals An Overview of Systematic Reviews: Complementary Therapies for Cancer Patients

2019 ◽  
Vol 18 ◽  
pp. 153473541989002 ◽  
Author(s):  
Seong Min Lee ◽  
Ho Cheol Choi ◽  
Min Kyung Hyun
Keyword(s):  
Side Effects ◽  
Cancer Patients ◽  
Systematic Reviews ◽  
Complementary Therapies ◽  
The United States ◽  
Assessment Tools ◽  
Cochrane Library ◽  
Future Research ◽  
Cancer Type

Introduction: This article critically examines the systematic reviews (SR) and meta-analysis (MA) of complementary therapies for cancer patients to appraise the evidence level, and offers suggestions for future research and practice. Methods: The Cochrane Library and MEDLINE were searched from their inception to January 2018, to identify SR and MA of complementary therapies available for cancer patients. Final selected SR and MA were methodologically evaluated for their quality by applying the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR2) instrument. Data extraction and risk of quality assessments were performed by 2 independent reviewers. Results: A total of 104 studies were included in the analysis. The majority of the individual clinical trials included in the SR and MA were performed in China (48%) and the United States (26.9%). Breast cancer was the most studied cancer type (25%), and acupuncture was the most studied intervention (21%). Side effects of cancer such as pain, depression, and fatigue were effectively managed with complementary therapies. The methodologically problematic items included not listing the excluded studies and lack of protocol or protocol registration. Conclusions: With increasing interest in research, complementary therapies appear to be beneficial in reducing side effects and raising the quality of life of cancer patients. Complementary therapies have generally been studied for all cancers, with acupuncture being the most researched, regardless of the cancer type. Since AMSTAR2 is a stricter assessment tool than before, future studies need to consider the risk of methodological bias with caution and discuss appropriate overall quality assessment tools.

Abstract P176: Metabolic Side Effects Of Systemic Corticosteroids - A Systematic Review

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Spoorthy Kulkarni ◽  
Hannah Durham ◽  
Luke Glover ◽  
Leslie Cousens ◽  
Parmis Blomgran ◽  
...  
Keyword(s):  
Side Effects ◽  
Adverse Events ◽  
Event Rate ◽  
Risk Of Bias ◽  
Adverse Event Rate ◽  
Cochrane Library ◽  
Exclusion Criteria ◽  
Metabolic Side Effects ◽  
Onset Diabetes ◽  
New Onset

Introduction: Metabolic adverse events associated with corticosteroid therapy (CT) are seen as a necessary evil in the management of a wide variety of inflammatory conditions. Evidence on the burden of dysglycaemia associated with CT strategies is mostly based on case- control studies. The aim of this study was to quantify metabolic side effects of systemic steroids as reported in randomised clinical trials (RCT). Methods: We searched Medline, Embase, Cochrane Library, Web of Science and Scopus for studies reporting adverse effects of CT in trials since database inception to 13/01/2020. We used a standardised data extraction form to collect information from eligible studies using predefined inclusion and exclusion criteria. Cochrane risk of bias tool 2 (ROB2) was used to assess risk of bias in the RCTs. The study was registered prospectively with PROSPERO (CRD42020161270). Results: The search identified 5446 studies. In total 120 blinded studies were identified for the mixed method review of AEs. There was significant heterogeneity with respect to steroid dose, treatment duration, condition treated, exclusion criteria in the studies, data collection methods for adverse events (AE) and definition for specific AEs. A significant increase in cases of new onset diabetes, hyperglycaemia, episodes of rise in blood pressure (BP) was noted. Average adverse event rate for new onset of diabetes in the studies (N=21, 27 CT arms) was 4.8% (72 events in 1477 participants, range: 0.85%-18.75%). Event rate of hyperglycaemia in the CT arms was 11.8% approximately (53 CT arms, 222 events in 1854 participants, range: 2.5%-69%). Rise in BP was reported in 53 CT arms in 42 studies, with average event rate of 12.8% (160 events in 1251 participants, range: 0.94%-30.4%). Other significant AEs associated with steroid use included weight gain, dyslipidaemia, insomnia, infections, osteoporosis and fractures. Conclusions: Risk of new onset diabetes and worsening of diabetes control is significant in patients treated with CT, although available evidence to estimate risk is heterogenous. Both, alternatives to corticosteroids which do not elevate blood glucose and accurate estimation of risk of dysglycaemia from well-designed prospective RCTs are urgently required.

scholarly journals Risks and benefits of antioxidant dietary supplement use during cancer treatment: protocol for a scoping review

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e047200
Author(s):  
L. Susan Wieland ◽  
Ilana Moffet ◽  
Sydney Shade ◽  
Ashkan Emadi ◽  
Cheryl Knott ◽  
...  
Keyword(s):  
Systematic Review ◽  
Side Effects ◽  
Cancer Treatment ◽  
Dietary Supplements ◽  
Systematic Reviews ◽  
Scoping Review ◽  
Cochrane Library ◽  
Antioxidant Supplementation ◽  
Dietary Antioxidant ◽  
Antioxidant Supplements

IntroductionAntioxidant dietary supplements are used by many patients with cancer to reduce the side effects of chemotherapy and improve prognosis. While some research indicates oral antioxidant supplementation reduces side effects and improves patient survival, other studies suggest the use of antioxidant dietary supplements may interfere with chemotherapy and reduce its curative effects. There is a need to clarify the evidence base on the impact of dietary antioxidant supplementation during chemotherapy on both side effect and treatment efficacy outcomes. We will use a scoping review approach to identify what systematic review evidence exists regarding beneficial and harmful effects of dietary antioxidant supplements when used during cancer treatment.Methods and analysisWe will use Arksey & O’Malley and Joanna Briggs Institute methods for scoping reviews. We will systematically search PubMed, Embase, CINAHL, Scopus, Dissertations & Theses Global and the Cochrane Library from inception to October 2020. Systematic reviews of randomised controlled trials of oral dietary antioxidant supplements used by participants receiving curative chemotherapy, radiotherapy or other biological therapy for cancer will be eligible. Two reviewers will screen citations and full texts for inclusion and chart data on research questions from included reviews. Two reviewers will assess the overall confidence in systematic review results using A Measurement Tool to Assess Systematic Reviews-2 (AMSTAR-2), and summarised evidence will focus on reviews rated at high or moderate overall confidence. Tables will be used to map existing evidence and identify evidence gaps for safety and effectiveness outcomes.Ethics and disseminationThis scoping review does not require ethical approval as it is a secondary assessment of available literature. The results will be presented at conferences and submitted for publication in a peer-reviewed journal. We will also disseminate results to community and clinical stakeholders and involve them in developing subsequent research to address critical existing gaps in the evidence as identified by the scoping review.

scholarly journals Metabolic Side Effects of Risperidone in Children and Adolescents With Early-Onset Schizophrenia

2008 ◽  
Vol 10 (06) ◽  
pp. 486-487 ◽  
Author(s):  
Jean-Louis Goeb ◽  
Sophie Marco ◽  
Alain Duhmael ◽  
Renaud Jardri ◽  
Geraldine Kechid ◽  
...  
Keyword(s):  
Side Effects ◽  
Children And Adolescents ◽  
Early Onset ◽  
Early Onset Schizophrenia ◽  
Metabolic Side Effects

scholarly journals Neuroleptic prescribing in an adolescent psychiatric in-patient unit

1996 ◽  
Vol 20 (9) ◽  
pp. 538-540 ◽  
Author(s):  
K. Lowe ◽  
H. Smith ◽  
A. Clark
Keyword(s):  
Clinical Practice ◽  
Children And Adolescents ◽  
Antipsychotic Medication ◽  
Royal College ◽  
Psychotic Disorders ◽  
Consensus Statement ◽  
Comprehensive Evaluation ◽  
High Dose ◽  
Age Group ◽  
Antipsychotic Prescribing

The Royal College of Psychiatrists' consensus statement suggests that prescribing high dose antipsychotic medication in children and adolescents should rarely be necessary. Our objective was to study the prescribing of antipsychotic medication in a regional adolescent unit during a three-year period. We found that antipsychotic prescribing on this unit is common in psychotic disorders and often high closes are required. This is not in keeping with the recommendations of the consensus statement. Review of clinical practice on other adolescent units is needed, together with a more comprehensive evaluation of the outcome of psychotic disorders in this age group.

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