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Open Access 01-12-2020 | Autism Spectrum Disorder | Research article

Acceptability, equity, and feasibility of using antipsychotics in children and adolescents with autism spectrum disorder: a systematic review

Authors: Gian Loreto D’Alò, Franco De Crescenzo, Laura Amato, Fabio Cruciani, Marina Davoli, Francesca Fulceri, Silvia Minozzi, Zuzana Mitrova, Gian Paolo Morgano, Franco Nardocci, Rosella Saulle, Holger Jens Schünemann, Maria Luisa Scattoni, on behalf of the ISACA guideline working group

Published in: BMC Psychiatry | Issue 1/2020

Abstract

Background

It is unclear whether the administration of antipsychotics to children and adolescents with autism spectrum disorders (ASD) is acceptable, equitable, and feasible.

Methods

We performed a systematic review to support a multidisciplinary panel in formulating a recommendation on antipsychotics, for the development of the Italian national guidelines for the management of ASD. A comprehensive search strategy was performed to find data related to intervention acceptability, health equity, and implementation feasibility. We used quantitative data from randomized controlled trials to perform a meta-analysis assessing the acceptability and tolerability of antipsychotics, and we estimated the certainty of the effect according to the GRADE approach. We extracted data from systematic reviews, primary studies, and grey literature, and we assessed the risk of bias and methodological quality of the published studies.

Results

Antipsychotics were acceptable (dropouts due to any cause: RR 0.61, 95% CI 0.48–0.78, moderate certainty of evidence) and well tolerated (dropouts due to adverse events: RR 0.99, 95% CI 0.55–1.79, low certainty of evidence) by children and adolescents with ASD. Parents and clinicians did not raise significant issues concerning acceptability. We did not find studies reporting evidence of reduced equity for antipsychotics in disadvantaged subgroups of children and adolescents with ASD. Workloads, cost barriers, and inadequate monitoring of metabolic adverse events were indirect evidence of concerns for feasibility.

Conclusion

Antipsychotics in children and adolescents with ASD were likely acceptable and possibly feasible. We did not find evidence of concern for equity.

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Title: Acceptability, equity, and feasibility of using antipsychotics in children and adolescents with autism spectrum disorder: a systematic review
Authors: Gian Loreto D’Alò
Franco De Crescenzo
Laura Amato
Fabio Cruciani
Marina Davoli
Francesca Fulceri
Silvia Minozzi
Zuzana Mitrova
Gian Paolo Morgano
Franco Nardocci
Rosella Saulle
Holger Jens Schünemann
Maria Luisa Scattoni
on behalf of the ISACA guideline working group
Publication date: 01-12-2020
Publisher: BioMed Central
Keywords: Autism Spectrum Disorder
Antipsychotics
Antipsychotics
Published in: BMC Psychiatry / Issue 1/2020
Electronic ISSN: 1471-244X
DOI: https://doi.org/10.1186/s12888-020-02956-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Acceptability, equity, and feasibility of using antipsychotics in children and adolescents with autism spectrum disorder: a systematic review

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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