Barriers and facilitators to uptake of systematic reviews by policy makers and health care managers: a scoping review

Tricco, Andrea C.; Cardoso, Roberta; Thomas, Sonia M.; Motiwala, Sanober S.; Sullivan, Shannon; Kealey, M. Ryan; Hemmelgarn, Brenda R.; Ouimet, Mathieu; Hillmer, Michael; Perrier, Laure; Shepperd, Sasha; Straus, Sharon E.

doi:10.1186/s13012-016-0370-1

Cited by 131 publications

(187 citation statements)

References 55 publications

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“…These individuals will be defined as follows:14 Policymakers: “individuals [non-elected] at some level of government; they may have some responsibility for making recommendations to others and may include regional and federal representation.”Healthcare managers: “individuals in a managerial or supervisory role in a healthcare organization with management or supervisory mandates, including public health officials.”Policy analysts: “individuals [non-elected] at some level of government; they may have some responsibility for analyzing data and may include regional and federal representation.”…”

Section: Methodsmentioning

confidence: 99%

Barriers, facilitators, strategies and outcomes to engaging policymakers, healthcare managers and policy analysts in knowledge synthesis: a scoping review protocol

et al. 2016

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IntroductionEngaging policymakers, healthcare managers and policy analysts in the conduct of knowledge synthesis can help increase its impact. This is particularly important for knowledge synthesis studies commissioned by decision-makers with limited timelines, as well as reviews of health policy and systems research. A scoping review will be conducted to assess barriers, facilitators, strategies and outcomes of engaging these individuals in the knowledge synthesis process.Methods and analysisWe will follow the Joanna Briggs Institute guidance for scoping reviews. Literature searches of electronic databases (eg, MEDLINE, EMBASE, Cochrane Library, ERIC, PsycINFO) will be conducted from inception onwards. The electronic search will be supplemented by searching for sources that index unpublished/difficult to locate studies (eg, GreyNet International database), as well as through scanning of reference lists of reviews on related topics. All study designs using either qualitative or quantitative methodologies will be eligible if there is a description of the strategies, barriers or facilitators, and outcomes of engaging policymakers, healthcare managers and policy analysts in the knowledge synthesis process. Screening and data abstraction will be conducted by 2 team members independently after a calibration exercise across the team. A third team member will resolve all discrepancies. We will conduct frequency analysis and thematic analysis to chart and characterise the literature, identifying data gaps and opportunities for future research, as well as implications for policy.Ethics and disseminationThis project was commissioned by the Alliance for Health Policy and Systems Research, WHO. The results will be used by Alliance Review Centers of health policy and systems research in low-income and middle-income countries that are conducting knowledge synthesis to inform health policymaking and decision-making. Our results will also be disseminated through conference presentations, train-the-trainer events, peer-reviewed publication and a 1-page policy brief that will be posted on the authors' websites.

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Section: Methodsmentioning

confidence: 99%

Barriers, facilitators, strategies and outcomes to engaging policymakers, healthcare managers and policy analysts in knowledge synthesis: a scoping review protocol

et al. 2016

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“…Possible reasons include costs, time, and knowledge and beliefs about systematic reviews 113. Undertaking international reviews for conditions across several countries would reduce overall costs.…”

Section: Discussionmentioning

confidence: 99%

Association between use of systematic reviews and national policy recommendations on screening newborn babies for rare diseases: systematic review and meta-analysis

Taylor‐Phillips

Stinton

Ruffano

et al. 2018

BMJ

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ObjectiveTo understand whether international differences in recommendations of whether to screen for rare diseases using the newborn blood spot test might in part be explained by use of systematic review methods.DesignSystematic review and meta-analysis.Data sourcesWebsite searches of 26 national screening organisations.Eligibility criteria for study selectionJournal articles, papers, legal documents, presentations, conference abstracts, or reports relating to a national recommendation on whether to screen for any condition using the newborn blood spot test, with no restrictions on date or language.Data extractionTwo reviewers independently assessed whether the recommendation for or against screening included systematic reviews, and data on test accuracy, benefits of early detection, and potential harms of overdiagnosis.AnalysisThe odds of recommending screening according to the use of systematic review methods was estimated across conditions using meta-analysis.Results93 reports were included that assessed 104 conditions across 14 countries, totalling 276 recommendations (units of analysis). Screening was favoured in 159 (58%) recommendations, not favoured in 98 (36%), and not recommended either way in 19 (7%). Only 60 (22%) of the recommendations included a systematic review. Use of a systematic review was associated with a reduced probability of screening being recommended (23/60 (38%)v136/216 (63%), odds ratio 0.17, 95% confidence interval 0.07 to 0.43). Of the recommendations, evidence for test accuracy, benefits of early detection, and overdiagnosis was not considered in 115 (42%), 83 (30%), and 211 (76%), respectively.ConclusionsUsing systematic review methods is associated with a reduced probability of screening being recommended. Many national policy reviews of screening for rare conditions using the newborn blood spot test do not assess the evidence on the key benefits and harms of screening.

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“…Systematic reviews and studies of barriers and facilitators to implementation of clinical guidelines have previously been conducted. [32] However, by engaging stakeholders directly in identifying barriers and facilitators and prioritizing guideline recommendations, they are better able to understand local challenges and opportunities for implementation, to select relevant and appropriate implementation strategies and tailor them to the local context. This approach also helps stakeholders link together the barriers and facilitators with implementation strategies to focus efforts on priority areas and issues.…”

Section: Discussionmentioning

confidence: 99%

Barriers, Facilitators and Priorities for Implementation of WHO Maternal and Perinatal Health Guidelines in Four Lower-Income Countries: A GREAT Network Research Activity

et al. 2016

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BackgroundHealth systems often fail to use evidence in clinical practice. In maternal and perinatal health, the majority of maternal, fetal and newborn mortality is preventable through implementing effective interventions. To meet this challenge, WHO’s Department of Reproductive Health and Research partnered with the Knowledge Translation Program at St. Michael’s Hospital (SMH), University of Toronto, Canada to establish a collaboration on knowledge translation (KT) in maternal and perinatal health, called the GREAT Network (Guideline-driven, Research priorities, Evidence synthesis, Application of evidence, and Transfer of knowledge). We applied a systematic approach incorporating evidence and theory to identifying barriers and facilitators to implementation of WHO maternal heath recommendations in four lower-income countries and to identifying implementation strategies to address these.MethodsWe conducted a mixed-methods study in Myanmar, Uganda, Tanzania and Ethiopia. In each country, stakeholder surveys, focus group discussions and prioritization exercises were used, involving multiple groups of health system stakeholders (including administrators, policymakers, NGOs, professional associations, frontline healthcare providers and researchers).ResultsDespite differences in guideline priorities and contexts, barriers identified across countries were often similar. Health system level factors, including health workforce shortages, and need for strengthened drug and equipment procurement, distribution and management systems, were consistently highlighted as limiting the capacity of providers to deliver high-quality care. Evidence-based health policies to support implementation, and improve the knowledge and skills of healthcare providers were also identified. Stakeholders identified a range of tailored strategies to address local barriers and leverage facilitators.ConclusionThis approach to identifying barriers, facilitators and potential strategies for improving implementation proved feasible in these four lower-income country settings. Further evaluation of the impact of implementing these strategies is needed.

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Barriers and facilitators to uptake of systematic reviews by policy makers and health care managers: a scoping review

Cited by 131 publications

References 55 publications

Barriers, facilitators, strategies and outcomes to engaging policymakers, healthcare managers and policy analysts in knowledge synthesis: a scoping review protocol

Barriers, facilitators, strategies and outcomes to engaging policymakers, healthcare managers and policy analysts in knowledge synthesis: a scoping review protocol

Association between use of systematic reviews and national policy recommendations on screening newborn babies for rare diseases: systematic review and meta-analysis

Barriers, Facilitators and Priorities for Implementation of WHO Maternal and Perinatal Health Guidelines in Four Lower-Income Countries: A GREAT Network Research Activity

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