Evidence mapPaperPMID 39093720Full record

ArticleBMJ mental health2024

Quality of melatonin use in children and adolescents: findings from a UK clinical audit.

Carol Paton, Paul Gringras, Alice Ruan, Ashley Liew, Olivia Rendora, Gaia Bove, Thomas R E Barnes

Abstract read
In one paragraph

Article in BMJ mental health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Carol PatonPrescribing Observatory for Mental Health, Royal College of Psychiatrists, London, UK Carol.Paton@nhs.net.ORCID http://orcid.org/0000-0001-7756-1031
Paul GringrasEvelina London Children's Hospital, King's College London, London, UK.
Alice RuanDepartment of Endocrinology, Imperial College London, London, UK.
Ashley LiewEvelina London Children's Hospital, King's College London, London, UK.ORCID http://orcid.org/0000-0002-3825-225X
Olivia RendoraPrescribing Observatory for Mental Health, Royal College of Psychiatrists, London, UK.ORCID http://orcid.org/0000-0002-7843-3426
Gaia BovePrescribing Observatory for Mental Health, Royal College of Psychiatrists, London, UK.ORCID http://orcid.org/0009-0001-9492-4452
Thomas R E BarnesPrescribing Observatory for Mental Health, Royal College of Psychiatrists, London, UK.ORCID http://orcid.org/0000-0002-2324-656X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMelatonin is commonly used to treat sleep disturbance in children and adolescents, although uncertainties about its optimal use remain.

objectiveTo determine to what extent prescribing of melatonin complies with evidence-based clinical practice standards.

methodsAs part of a quality improvement programme, the Prescribing Observatory for Mental Health conducted a retrospective clinical audit in UK services for children and adolescents.

findingsData were submitted for 4151 children and adolescents up to 18 years of age, treated with melatonin: 3053 (74%) had a diagnosis of neurodevelopmental disorder. In 2655 (73%) of the 3651 patients prescribed melatonin to be taken regularly, the main reason was to reduce sleep latency (time taken to fall asleep). In 409 patients recently starting melatonin, a non-pharmacological intervention had already been tried in 279 (68%). The therapeutic response of patients early in treatment (n=899) and on long-term treatment (n=2353) had been assessed and quantified in 36% and 31%, respectively, while for review of side effects, the respective proportions were 46% and 43%. Planned treatment breaks were documented in 317 (13%) of those on long-term treatment.

conclusionsMelatonin was predominantly prescribed for evidence-based clinical indications, but the clinical review and monitoring of this treatment fell short of best practice. CLINICAL IMPLICATIONS: With limited methodical review of melatonin use in their patients, clinicians will fail to garner reliable information on its risks and benefits for individual patients. The lack of such practice-based evidence may increase the risk of melatonin being inappropriately targeted or continued despite being ineffective or no longer indicated.

Indexed as

Clinical AuditMelatoninAdolescentCentral Nervous System DepressantsChildChild, PreschoolFemaleHumansInfantMaleRetrospective StudiesSleep Wake DisordersUnited KingdomCentral Nervous System DepressantsMelatoninchild & adolescent psychiatrysleep

Identifiers

PMID39093720
PMCPMC10806856

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.