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Pharmacological and non-pharmacological interventions for adults with ADHD: protocol for a systematic review and network meta-analysis
INTRODUCTION: It is unclear how pharmacological and non-pharmacological interventions compare with each other in terms of efficacy and tolerability for core symptoms and additional problems in adults with attention-deficit/hyperactivity disorder (ADHD). We aim to conduct the first network meta-analy...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8919448/ https://www.ncbi.nlm.nih.gov/pubmed/35277411 http://dx.doi.org/10.1136/bmjopen-2021-058102 |
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author | Cortese, Samuele Del Giovane, Cinzia Chamberlain, Samuel Philipsen, Alexandra Young, Susan Bilbow, Andrea Cipriani, Andrea |
author_facet | Cortese, Samuele Del Giovane, Cinzia Chamberlain, Samuel Philipsen, Alexandra Young, Susan Bilbow, Andrea Cipriani, Andrea |
author_sort | Cortese, Samuele |
collection | PubMed |
description | INTRODUCTION: It is unclear how pharmacological and non-pharmacological interventions compare with each other in terms of efficacy and tolerability for core symptoms and additional problems in adults with attention-deficit/hyperactivity disorder (ADHD). We aim to conduct the first network meta-analysis (NMA) comparing pharmacological and non-pharmacological interventions (or their combinations) in adults with ADHD. METHODS AND ANALYSIS: We will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for NMAs. We will search a broad set of electronic databases/registries and contact drug companies and experts in the field to retrieve published and unpublished randomised controlled trials (RCTs) (parallel or cross-over) of medications (either licensed or unlicensed) and any non-pharmacological intervention in adults (≥18 years) with ADHD. Primary outcomes will be: (1) change in severity of ADHD core symptoms, and (2) acceptability (all-cause discontinuation). Secondary outcomes will include tolerability (drop-out due to side effects) and change in the severity of emotional dysregulation, executive dysfunctions and quality of life. The risk of bias in each individual RCT included in the NMA will be assessed using the Cochrane Risk of Bias tool-version 2. We will evaluate the transitivity assumption comparing the distribution of possible effect modifiers across treatment comparisons. We will perform Bayesian NMA for each outcome with random-effects model in OpenBUGS. Pooled estimates of NMA will be obtained using the Markov Chains Monte Carlo method. We will judge the credibility in the evidence derived from the NMA using the CINeMA tool (which includes assessment of publication bias). We will conduct a series of sensitivity analyses to assess the robustness of the findings. ETHICS AND DISSEMINATION: As this is the protocol for an aggregate-data level NMA, ethical approval will not be required. Results will be disseminated at national/international conferences and in peer-reviewed journals. PROSPERO REGISTRATION NUMBER: CRD42021265576. |
format | Online Article Text |
id | pubmed-8919448 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-89194482022-03-25 Pharmacological and non-pharmacological interventions for adults with ADHD: protocol for a systematic review and network meta-analysis Cortese, Samuele Del Giovane, Cinzia Chamberlain, Samuel Philipsen, Alexandra Young, Susan Bilbow, Andrea Cipriani, Andrea BMJ Open Mental Health INTRODUCTION: It is unclear how pharmacological and non-pharmacological interventions compare with each other in terms of efficacy and tolerability for core symptoms and additional problems in adults with attention-deficit/hyperactivity disorder (ADHD). We aim to conduct the first network meta-analysis (NMA) comparing pharmacological and non-pharmacological interventions (or their combinations) in adults with ADHD. METHODS AND ANALYSIS: We will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement for NMAs. We will search a broad set of electronic databases/registries and contact drug companies and experts in the field to retrieve published and unpublished randomised controlled trials (RCTs) (parallel or cross-over) of medications (either licensed or unlicensed) and any non-pharmacological intervention in adults (≥18 years) with ADHD. Primary outcomes will be: (1) change in severity of ADHD core symptoms, and (2) acceptability (all-cause discontinuation). Secondary outcomes will include tolerability (drop-out due to side effects) and change in the severity of emotional dysregulation, executive dysfunctions and quality of life. The risk of bias in each individual RCT included in the NMA will be assessed using the Cochrane Risk of Bias tool-version 2. We will evaluate the transitivity assumption comparing the distribution of possible effect modifiers across treatment comparisons. We will perform Bayesian NMA for each outcome with random-effects model in OpenBUGS. Pooled estimates of NMA will be obtained using the Markov Chains Monte Carlo method. We will judge the credibility in the evidence derived from the NMA using the CINeMA tool (which includes assessment of publication bias). We will conduct a series of sensitivity analyses to assess the robustness of the findings. ETHICS AND DISSEMINATION: As this is the protocol for an aggregate-data level NMA, ethical approval will not be required. Results will be disseminated at national/international conferences and in peer-reviewed journals. PROSPERO REGISTRATION NUMBER: CRD42021265576. BMJ Publishing Group 2022-03-11 /pmc/articles/PMC8919448/ /pubmed/35277411 http://dx.doi.org/10.1136/bmjopen-2021-058102 Text en © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Mental Health Cortese, Samuele Del Giovane, Cinzia Chamberlain, Samuel Philipsen, Alexandra Young, Susan Bilbow, Andrea Cipriani, Andrea Pharmacological and non-pharmacological interventions for adults with ADHD: protocol for a systematic review and network meta-analysis |
title | Pharmacological and non-pharmacological interventions for adults with ADHD: protocol for a systematic review and network meta-analysis |
title_full | Pharmacological and non-pharmacological interventions for adults with ADHD: protocol for a systematic review and network meta-analysis |
title_fullStr | Pharmacological and non-pharmacological interventions for adults with ADHD: protocol for a systematic review and network meta-analysis |
title_full_unstemmed | Pharmacological and non-pharmacological interventions for adults with ADHD: protocol for a systematic review and network meta-analysis |
title_short | Pharmacological and non-pharmacological interventions for adults with ADHD: protocol for a systematic review and network meta-analysis |
title_sort | pharmacological and non-pharmacological interventions for adults with adhd: protocol for a systematic review and network meta-analysis |
topic | Mental Health |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8919448/ https://www.ncbi.nlm.nih.gov/pubmed/35277411 http://dx.doi.org/10.1136/bmjopen-2021-058102 |
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