Reducing self-harm in adolescents: the RISA-IPD individual patient data meta-analysis and systematic review
Year: 2023
Type: review
Abstract: Background: Self-harm is common in adolescents and a major public health concern. Evidence for effective interventions is lacking. An individual patient data meta-analysis has the potential to provide more reliable estimates of the effects of therapeutic interventions for self-harm than conventional meta-analyses, to explore which treatments are best suited to certain groups. Method: A systematic review and individual patient data meta-analysis of randomised controlled trials of therapeutic interventions to reduce repeat self-harm in adolescents who had a history of self-harm and presented to clinical services. Primary outcome was repetition of self-harm. The methods employed for searches, study screening and selection, and risk of bias assessment are described, with an overview of the outputs of the searching, selection and quality assessment processes. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance is followed. Results: We identified a total 39 eligible studies, from 10 countries, where we sought Individual Patient Data (IPD), of which the full sample of participants were eligible in 18 studies and a partial sample of participants were eligible in 21 studies. We obtained IPD from 26 studies of 3448 eligible participants. For our primary outcome, repetition of self-harm, only 6 studies were rated as low risk of bias with 10 rated as high risk (although 2 of these were for secondary outcomes only). Conclusions: Obtaining individual patient data for meta-analyses is possible but very time-consuming, despite clear guidance from funding bodies that researchers should share their data appropriately. More attention needs to be paid to seeking appropriate consent from study participants for (pseudo) anonymised data-sharing and institutions need to collaborate on agreeing template data-sharing agreements. Researchers and funders need to consider issues of research design more carefully. Our next step is to analyse all the data we have collected to see if it will tell us more about how we might prevent repetition of self-harm in young people. Funding: This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment programme as award number 17/117/11.
Source: Health Technology Assessment
DOI: 10.3310/gtnt6331
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: diamond
Awards: Function REplacement in repeated Self-Harm: Standardising Therapeutic Assessment and the Related Therapy: FReSH START, G1091684523, G1279655174, An evaluation of quality improvement collaboratives aligned to a national audit to improve the uptake of insulin pumps for people with diabetes, G2971517736, G3033929502, Using digital health to transform the management of long-term conditions in the NHS: Assessing real-world patient experience and empowerment and improvements to productivity and capacity, Caring Optimally: promoting effective Mouth MInuTes in care homes (COMMIT Study), REcruiting and RetAining nurses, and carers in Care Homes: what works, for which staff, under what circumstances, and at what cost? The REACH Realist Review, CanSense-CRC : Development and optimisation of a blood test for the early detection of bowel cancer in primary care, ARIEL: A biomarker enrichment trial of anti-EGFR agents in patients with advanced colorectal cancer with wild-type RAS and right primary tumour location, Developing and evaluating a diabetes self-management intervention for people with severe mental illness: The DIAMONDS programme (Diabetes and Mental Illness, Improving Outcomes and Self-management), Biologics in refractory vasculitis (BIOVAS): A pragmatic, randomised, double-blind, placebo-controlled, modified-crossover trial of biologic therapy for refractory primary non-ANCA associated vasculitis in adults and children, Mammographic surveillance in breast cancer patients aged 50 years or older, Evaluation of a sustainable obesity prevention programme delivered at scale ‘HENRY’: Effectiveness, cost-effectiveness and its role in obesity prevention within the wider complex system, DANTE - A randomised phase III trial to evaluate the duration of anti-PD1 monoclonal antibody treatment in patients with metastatic melanoma, G8563064727, A multicentre, randomised controlled trial of Laparoscopic versus Open Colorectal Surgery in the Acute Setting, ReducIng Self-Harm in Adolescents: Individual Participant meta-analysis (RISA-IPD)
OpenAlex ID: W4400840495