Optimisation du soutien fourni par la médecine générale aux adultes autistes : protocole de revue réaliste

Titre original en anglais : Optimising general practice support for autistic adults: a realist review protocol

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Birtwell, K., Planner, C., Epton, T., Gowen, E., Corsellis, E., Botha, M., Longley, S., Khan, G., Stratton, C., & Wong, G. (2025). Optimising general practice support for autistic adults: a realist review protocol. Systematic Reviews, 14(1), 184-184. https://doi.org/10.1186/s13643-025-02936-7

Date de publication: 29/09/2025 Ajout dans AutiHub: 05/07/2026 Type: Article Langue de l’article: Anglais
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Auteurs

Auteur·ices des publications
10
Auteur·ices de la publication identifié·es comme autistes
1 / 10 (10,0 %)
  1. Kelly Birtwell
  2. Claire Planner
  3. Tracy Epton
  4. Emma Gowen
  5. Emily Corsellis
  1. Monique Botha *
  2. Sophie Longley
  3. Ghafaria Khan
  4. Cathy Stratton
  5. Geoff Wong

Résumé

CONTEXTE : Les troubles de santé mentale et physique sont plus fréquents chez les personnes autistes que chez les personnes non autistes, notamment l’anxiété, la dépression, la suicidalité, les problèmes gastro-intestinaux, le cancer, l’épilepsie et les maladies cardiaques. La médecine générale constitue souvent le premier point de contact pour les patients, mais la recherche a montré que les personnes autistes rencontrent des obstacles aux soins de santé, déclarent une satisfaction moindre à l’égard des soins de santé et présentent davantage de besoins de santé non satisfaits que les personnes non autistes. Cela peut être dû à des malentendus concernant les besoins des personnes autistes, à des styles de communication différents, à l’environnement de la clinique et aux difficultés à prendre et à obtenir des rendez-vous, aggravés par la lente diffusion des résultats de recherche. Notre objectif est de déterminer comment, pourquoi et dans quelle mesure la médecine générale soutient les adultes autistes avec et sans déficience intellectuelle (ID) tout au long de leur vie, afin de proposer des améliorations de la pratique. MÉTHODES : Nous réaliserons une revue réaliste, qui est une revue systématique guidée par la théorie. Des bases de données électroniques seront consultées, notamment MEDLINE, PsycInfo, EMBASE, la Cochrane Database of Systematic Reviews, CINAHL, Scopus, ASSIA et des sources de littérature grise (par exemple, Google Scholar). Pour être inclus, les articles devront porter sur la médecine générale, les adultes autistes âgés de 18 ans et plus, contenir des informations pertinentes dans un contexte britannique et être rédigés en anglais. Tout plan d’étude ou type d’article pourra être inclus et les articles seront évalués quant à leur pertinence et leur rigueur. Conformément aux méthodes de synthèse réaliste, nous identifierons les contextes, mécanismes et résultats pertinents et élaborerons une théorie de programme pour expliquer comment, pourquoi et à quel moment la médecine générale soutient de manière optimale (ou non) les adultes autistes. Nous chercherons également à identifier les ressources disponibles pour la médecine générale et utilisées par elle afin de soutenir les adultes autistes. Nous impliquerons les parties prenantes à chaque étape de la revue, y compris des personnes autistes, des membres de la famille et des professionnels de santé (y compris le personnel de médecine générale). La revue sera rapportée conformément aux normes de publication RAMESES. DISCUSSION : Les résultats éclaireront des recommandations destinées i) à la médecine générale concernant des adaptations potentiellement utiles des services, et ii) aux personnes autistes afin de les aider à obtenir le soutien dont elles ont besoin. Cela contribuera à améliorer l’accès aux soins de médecine générale et l’engagement envers ces soins, et ainsi à potentiellement améliorer la santé et le bien-être des personnes autistes. ENREGISTREMENT DE LA REVUE SYSTÉMATIQUE : PROSPERO CRD42024545403.

BACKGROUND: Mental and physical health conditions are more common in autistic than non-autistic people, including anxiety, depression, suicidality, gastrointestinal problems, cancer, epilepsy, and heart disease. General practice is often the first point of contact for patients, yet research has found that autistic people face barriers to healthcare, report lower satisfaction with healthcare, and have more unmet health needs than non-autistic people. This can be due to misunderstandings about the needs of autistic people, different communication styles, the clinic environment, and challenges making and getting to appointments, compounded by slow dissemination of research findings. Our aim is to find out how, why, and to what extent general practice supports autistic adults with and without intellectual disabilities (ID) throughout their lives, in order to suggest improvements to practice. METHODS: We will conduct a realist review which is a theory-driven systematic review. Electronic databases will be searched including MEDLINE, PsycInfo, EMBASE, the Cochrane Database of Systematic Reviews, CINAHL, Scopus, ASSIA and grey literature sources (e.g. Google Scholar). To be included articles must concern general practice, autistic adults aged 18 and over, contain information relevant to a UK setting, and be written in English. Any study design or article type may be included and articles will be assessed for relevance and rigour. In line with realist synthesis methods we will identify relevant contexts, mechanisms and outcomes and develop a programme theory to explain how, why, and when general practice optimally supports (or not) autistic adults. We will also seek to identify resources that are available for and used by general practice to support autistic adults. We will involve stakeholders in each stage of the review including autistic individuals, family members, and healthcare professionals (including general practice staff). The review will be reported in line with the RAMESES publication standards. DISCUSSION: The findings will inform guidance for i) general practice about potentially helpful adaptations to service, and ii) autistic people to help them gain the support they need. This will help to improve access to and engagement with general practice care, and thus potentially improve the health and wellbeing of autistic individuals. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42024545403.

Bibliographie citée par cette référence

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Vue d’ensemble de l’inclusion dans la bibliographie

Ces indicateurs décrivent la bibliographie citée importée pour cette publication. Les métriques de références citées utilisent le total des références citées comme dénominateur. Les métriques d’auteurices cité·es indiquent si elles utilisent toutes les occurrences d’auteurices cité·es ou seulement les occurrences rattachées à des auteurices déjà intégré·es à la base de données AutiHub. Ils utilisent les rattachements mis en cache entre les auteurices cité·es et les auteurices intégré·es à la base de données AutiHub. Dernier calcul : 16/08/2026 11:30.

Références citées
51
Nombre total de références citées intégrées pour cette publication.
Références citées avec un·e auteur·ice identifié·e comme autiste
6 / 51 (11,8 %)
Occurrences d’auteur·ices cité·es identifié·es comme autistes
10 / 202 (5,0 %)
Parmi les occurrences rattachées à des auteurices intégré·es à la base de données AutiHub : 10 / 82 (12,2 %). Auteurices cité·es distinct·es identifié·es comme autistes : 9 / 182 (4,9 %).
Occurrences citées rattachées à la base AutiHub
82 / 202 (40,6 %)
Auteurices cité·es distinct·es rattaché·es : 65 / 182 (35,7 %)
Occurrences rattachées, non identifiées comme autistes
72 / 82 (87,8 %)
Parmi les seules occurrences rattachées. Sur l’ensemble des occurrences d’auteurices cité·es : 72 / 202 (35,6 %). Auteurices cité·es distinct·es rattaché·es, non identifié·es comme autistes : 56 / 65 (86,2 %).
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