Patient, Treatment, and Health Care Utilization Variables Associated with Adherence to Metabolic Monitoring Practices in Children and Adolescents Taking Second-Generation Antipsychotics

Coughlin, Mary; Goldie, Catherine; Tranmer, Joan; Khalid‐Khan, Sarosh; Tregunno, Deborah

doi:10.1177/0706743717751693

Cited by 21 publications

(28 citation statements)

References 52 publications

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“…Our study findings were in line with previous studies that suggested that SGA treatment poses major metabolic risks for children (6,7,26). Despite these findings, and the existing guidelines, monitoring practices have often remained irregular (16)(17)(18)(19)(20). In our study, the baseline information necessary for detecting changes in growth and the laboratory test values were seldom complete.…”

Section: Discussionsupporting

confidence: 88%

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Current follow‐up practices often fail to detect metabolic and neurological adverse reactions in children treated with second‐generation antipsychotics

et al. 2019

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Section: Discussionsupporting

confidence: 88%

“…These findings highlight the need for proper monitoring practices for children treated with SGAs. There are guidelines on follow-up practices, but there has been limited systematic monitoring, despite the evidence of SGA-related adverse reactions (16)(17)(18)(19)(20).…”

Section: Introductionmentioning

confidence: 99%

Current follow‐up practices often fail to detect metabolic and neurological adverse reactions in children treated with second‐generation antipsychotics

et al. 2019

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“…As adolescents are particularly susceptible to atypical antipsychotic-induced weight gain, increased metabolic monitoring is urgently recommended for improving treatment outcomes [ 38 – 40 ]. Weight gain may decrease medication adherence [ 41 , 42 ].…”

Section: Discussionmentioning

confidence: 99%

Lurasidone compared to other atypical antipsychotic monotherapies for adolescent schizophrenia: a systematic literature review and network meta-analysis

Arango

Ng-Mak

Finn

et al. 2019

Eur Child Adolesc Psychiatry

186

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This network meta-analysis assessed the efficacy and tolerability of lurasidone versus other oral atypical antipsychotic monotherapies in adolescent schizophrenia. A systematic literature review identified 13 randomized controlled trials of antipsychotics in adolescents with schizophrenia-spectrum disorders. A Bayesian network meta-analysis compared lurasidone to aripiprazole, asenapine, clozapine, olanzapine, paliperidone extended-release (ER), quetiapine, risperidone, and ziprasidone. Outcomes included Positive and Negative Syndrome Scale (PANSS), Clinical Global Impressions-Severity (CGI-S), weight gain, all-cause discontinuation, extrapyramidal symptoms (EPS), and akathisia. Results were reported as median differences for continuous outcomes and odds ratios (ORs) for binary outcomes, along with 95% credible intervals (95% CrI). Lurasidone was significantly more efficacious than placebo on the PANSS (− 7.95, 95% CrI − 11.76 to − 4.16) and CGI-S (− 0.44, 95% CrI − 0.67 to − 0.22) scores. Lurasidone was associated with similar weight gain to placebo and statistically significantly less weight gain versus olanzapine (− 3.62 kg, 95% CrI − 4.84 kg to − 2.41 kg), quetiapine (− 2.13 kg, 95% CrI − 3.20 kg to − 1.08 kg), risperidone (− 1.16 kg, 95% CrI − 2.14 kg to − 0.17 kg), asenapine (− 0.98 kg, 95% CrI − 1.71 kg to − 0.24 kg), and paliperidone ER (− 0.85 kg, 95% CrI − 1.57 kg to − 0.14 kg). The odds of all-cause discontinuation were significantly lower for lurasidone than aripiprazole (OR = 0.28, 95% CrI 0.10-0.76) and paliperidone ER (OR = 0.25, 95% CrI 0.08-0.81) and comparable to other antipsychotics. Rates of EPS and akathisia were similar for lurasidone and other atypical antipsychotics. In this network meta-analysis of atypical antipsychotics in adolescent schizophrenia, lurasidone was associated with similar efficacy, less weight gain, and lower risk of all-cause discontinuation compared to other oral atypical antipsychotics.

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“…These studies also sought to distinguish which atypical antipsychotic was prescribed. They made it possible to assess the relative frequency of prescription of one drug compared to others within the same class, although rarely an estimate of prevalence (Raebel et al 2014;Chen et al 2018;Coughlin et al 2018). In a large U.S. study on the monitoring of diabetic risk in 16,000 children and adolescents from 10 North American sites receiving an atypical antipsychotic, 31% were receiving aripiprazole (the first prescription being risperidone, 43%), leading to the conclusion that monitoring was very poor since only 11% of the children and adolescents had their glucose or hemoglobin A1C monitored (Raebel et al 2014).…”

Section: Us Epidemiological Data On Aripiprazolementioning

confidence: 99%

Aripiprazole in Children and Adolescents

Coustals

Ménard

Cohen

2021

Journal of Child and Adolescent Psychopharmacology

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Objective: To review the use of aripiprazole in children and adolescents. Methods: Medline and Embase databases were systematically searched using the keywords aripiprazole and child or adolescent over the period from 2000 to 2019. The initial screen yielded 163 publications, from which 99 studies were reviewed. Results: Aripiprazole is one of the most widely prescribed atypical antipsychotics. Like others, its use in children and adolescents is becoming commonplace and occurs in off-label indications. Aripiprazole has proven efficacy for several indications in children and adolescents, including schizophrenia, bipolar disorder, Tourette's syndrome, and behavioral impairments associated with autism and intellectual disability. Adverse effects are more important in children and adolescents than adults, particularly weight gain, drowsiness, extrapyramidal effects, and metabolic effects, even though the latter may appear less important than with other atypical antipsychotics. Severe adverse effects often occur in multiple-prescription settings. At present, postprescription monitoring is very poor. Conclusion: Aripiprazole has proven efficacy for several indications in children and adolescents. However, its use requires clinical and paraclinical monitoring to assess the occurrence of adverse events that may challenge the benefit/risk ratio. In addition, off-label prescriptions should be limited, as they appear to account for a significant proportion of aripiprazole use worldwide.

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Patient, Treatment, and Health Care Utilization Variables Associated with Adherence to Metabolic Monitoring Practices in Children and Adolescents Taking Second-Generation Antipsychotics

Abstract: Findings from this study highlight the need for better metabolic monitoring for children and adolescents taking SGAs. Enhanced focus on opportunities for multidisciplinary collaboration is needed to improve the quality of care offered to this population.

Cited by 21 publications

References 52 publications

Current follow‐up practices often fail to detect metabolic and neurological adverse reactions in children treated with second‐generation antipsychotics

Current follow‐up practices often fail to detect metabolic and neurological adverse reactions in children treated with second‐generation antipsychotics

Lurasidone compared to other atypical antipsychotic monotherapies for adolescent schizophrenia: a systematic literature review and network meta-analysis

Aripiprazole in Children and Adolescents

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