A systematic review and evidence synthesis of qualitative studies to identify primary care clinicians' barriers and enablers to the management of osteoarthritis

IntroductionStroke is a frequent disease in the older population of Western Europe with aphasia as a common consequence. Aphasia is known to impede targeting treatment to individual patients’ needs and therefore may reduce treatment success. In Germany, the postacute care of patients who had stroke is provided by different healthcare institutions of different sectors (rehabilitation, nursing and primary care) with substantial difficulties to coordinate services. We will conduct two qualitative evidence syntheses (QESs) aiming at exploring distinct healthcare needs and desires of older people living with poststroke aphasia. We thereby hope to support the development of integrated care models based on needs of patients who are very restricted to communicate them. Since various methods of QESs exist, the aim of the study embedding the two QESs was to determine if findings differ according to the approach used.Methods and analysisWe will conduct two QESs by using metaethnography (ME) and thematic synthesis (ThS) independently to synthesise the findings of primary qualitative studies. The main differences between these two methods are the underlying epistemologies (idealism (ME) vs realism (ThS)) and the type of research question (emerging (ME) vs fixed (ThS)).We will search seven bibliographical databases. Inclusion criteria comprise: patients with poststroke aphasia, aged 65 years and older, studies in German/English, all types of qualitative studies concerning needs and desires related to healthcare or the healthcare system. The protocol was registered in the International Prospective Register of Systematic Reviews, follows Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines and includes three items from the Enhancing Transparency in Reporting the synthesis of Qualitative Research checklist.Ethics and disseminationEthical approval is not required. Findings will be published in a peer-reviewed journal and presented on national conferences.

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The lived experience of people with obesity: study protocol for a systematic review and synthesis of qualitative studies

Systematic Reviews ◽

10.1186/s13643-021-01706-5 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Emma Farrell ◽

Marta Bustillo ◽

Carel W. le Roux ◽

Joe Nadglowski ◽

Eva Hollmann ◽

...

Keyword(s):

Systematic Review ◽

Lived Experience ◽

Health Care Providers ◽

Evidence Synthesis ◽

Qualitative Studies ◽

Qualitative Evidence Synthesis ◽

Care Providers ◽

Critical Appraisal Skills ◽

Health Complications

Abstract Background Obesity is a prevalent, complex, progressive and relapsing chronic disease characterised by abnormal or excessive body fat that impairs health and quality of life. It affects more than 650 million adults worldwide and is associated with a range of health complications. Qualitative research plays a key role in understanding patient experiences and the factors that facilitate or hinder the effectiveness of health interventions. This review aims to systematically locate, assess and synthesise qualitative studies in order to develop a more comprehensive understanding of the lived experience of people with obesity. Methods This is a protocol for a qualitative evidence synthesis of the lived experience of people with obesity. A defined search strategy will be employed in conducting a comprehensive literature search of the following databases: PubMed, Embase, PsycInfo, PsycArticles and Dimensions (from 2011 onwards). Qualitative studies focusing on the lived experience of adults with obesity (BMI >30) will be included. Two reviewers will independently screen all citations, abstracts and full-text articles and abstract data. The quality of included studies will be appraised using the critical appraisal skills programme (CASP) criteria. Thematic synthesis will be conducted on all of the included studies. Confidence in the review findings will be assessed using GRADE CERQual. Discussion The findings from this synthesis will be used to inform the EU Innovative Medicines Initiative (IMI)-funded SOPHIA (Stratification of Obesity Phenotypes to Optimize Future Obesity Therapy) study. The objective of SOPHIA is to optimise future obesity treatment and stimulate a new narrative, understanding and vocabulary around obesity as a set of complex and chronic diseases. The findings will also be useful to health care providers and policy makers who seek to understand the experience of those with obesity. Systematic review registration PROSPERO CRD42020214560.

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Barriers and Enablers to Objective Testing for Asthma and COPD in Primary Care: A Systematic Review Using the Theoretical Domains Framework

CHEST Journal ◽

10.1016/j.chest.2021.10.030 ◽

2021 ◽

Author(s):

Janet Yamada ◽

Jeffrey Lam Shin Cheung ◽

Myriam Gagne ◽

Carolyn Spiegel-Feld ◽

Shawn D. Aaron ◽

...

Keyword(s):

Systematic Review ◽

Primary Care ◽

Theoretical Domains Framework ◽

Objective Testing ◽

Barriers And Enablers

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Systematic review of barriers and enablers to the delivery of palliative care by primary care practitioners

Palliative Medicine ◽

10.1177/0269216319865414 ◽

2019 ◽

Vol 33 (9) ◽

pp. 1131-1145 ◽

Cited By ~ 9

Author(s):

Mariko L Carey ◽

Alison C Zucca ◽

Megan AG Freund ◽

Jamie Bryant ◽

Anne Herrmann ◽

...

Keyword(s):

Systematic Review ◽

Primary Care ◽

Palliative Care ◽

Care Delivery ◽

Primary Care Providers ◽

Healthcare Services ◽

Care Providers ◽

Eligibility Criteria ◽

Barriers And Enablers ◽

Primary Care Practitioners

Background: There is increasing demand for primary care practitioners to play a key role in palliative care delivery. Given this, it is important to understand their perceptions of the barriers and enablers to optimal palliative care, and how commonly these are experienced. Aim: To explore the type and prevalence of barriers and enablers to palliative care provision reported by primary care practitioners. Design: A systematic review of quantitative data-based articles was conducted. Data sources: Medline, Embase and PsychINFO databases were searched for articles published between January 2007 and March 2019. Data synthesis: Abstracts were assessed against the eligibility criteria by one reviewer and a random sample of 80 articles were blind coded by a second author. Data were extracted from eligible full-texts by one author and checked by a second. Given the heterogeneity in the included studies’ methods and outcomes, a narrative synthesis was undertaken. Results: Twenty-one studies met the inclusion criteria. The most common barriers related to bureaucratic procedures, communication between healthcare professionals, primary care practitioners’ personal commitments, and their skills or confidence. The most common enablers related to education, nurses and trained respite staff to assist with care delivery, better communication between professionals, and templates to facilitate referral to out-of-hours services. Conclusion: A holistic approach addressing the range of barriers reported in this review is needed to support primary care providers to deliver palliative care. This includes better training and addressing barriers related to the interface between healthcare services.

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Postsurgical rehabilitation for adults with low back pain with or without radiculopathy who were treated surgically: protocol for a mixed studies systematic review

BMJ Open ◽

10.1136/bmjopen-2020-036817 ◽

2020 ◽

Vol 10 (3) ◽

pp. e036817 ◽

Cited By ~ 1

Author(s):

Carol Cancelliere ◽

Jessica J. Wong ◽

Hainan Yu ◽

Margareta Nordin ◽

Silvano Mior ◽

...

Keyword(s):

Systematic Review ◽

Low Back Pain ◽

Back Pain ◽

Sports Medicine ◽

Evidence Synthesis ◽

Meta Analysis ◽

Empirical Studies ◽

Qualitative Studies ◽

Low Back ◽

Sequential Approach

IntroductionSurgical rates for low back pain (LBP) have been increasing in Europe, North America and Asia. Many patients treated surgically will require postsurgical rehabilitation. Little is known about the effectiveness of postsurgical rehabilitation interventions on health outcomes or about patients’ experiences with these interventions.ObjectivesTo conduct a mixed studies systematic review of quantitative and qualitative studies regarding: (1) the effectiveness and safety of postsurgical rehabilitation interventions for adults with LBP treated surgically and (2) the experiences of patients, healthcare providers, caregivers or others involved with the rehabilitation.Methods and analysisWe will search MEDLINE, Embase, PsycINFO, CINAHL, the Index to Chiropractic Literature, the Cochrane Controlled Register of Trials and the Rehabilitation & Sports Medicine Source for peer-reviewed empirical studies published from inception in any language. Studies using quantitative, qualitative and mixed methodologies will be included. We will also search reference lists of all eligible articles. Data extraction will include type of presurgical pathology, indication for surgery, surgical procedure, how the intervention was delivered and by whom, context and setting. We will conduct a quality assessment of each study and consider study quality in our evidence synthesis. We will use a sequential approach at the review level to synthesise and integrate data. First, we will synthesise the quantitative and qualitative studies independently, conducting a meta-analysis of the quantitative studies if appropriate and thematic synthesis of the qualitative studies. Then, we will integrate the quantitative and qualitative evidence by juxtaposing the findings in a matrix.Ethics and disseminationEthical approval is not required for this knowledge synthesis. Findings will be disseminated through knowledge translation activities including: (1) presentations at national and international conferences and scientific meetings; (2) presentations to local and international stakeholders; (3) publications in peer-reviewed journals and (4) posts on organisational websites.PROSPERO registration numberCRD42019134607.

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Barriers to primary care clinician adherence to clinical guidelines for the management of low back pain: protocol of a systematic review and meta-synthesis of qualitative studies

BMJ Open ◽

10.1136/bmjopen-2014-007265 ◽

2015 ◽

Vol 5 (4) ◽

pp. e007265-e007265 ◽

Cited By ~ 14

Author(s):

S. C. Slade ◽

P. Kent ◽

T. Bucknall ◽

E. Molloy ◽

S. Patel ◽

...

Keyword(s):

Systematic Review ◽

Primary Care ◽

Low Back Pain ◽

Back Pain ◽

Clinical Guidelines ◽

Qualitative Studies ◽

Low Back ◽

Primary Care Clinician

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Barriers and enablers to screening and diagnosing depression and diabetes distress in people with type 2 diabetes mellitus; protocol of a qualitative evidence synthesis

HRB Open Research ◽

10.12688/hrbopenres.12947.1 ◽

2019 ◽

Vol 2 ◽

pp. 26 ◽

Cited By ~ 1

Author(s):

Niamh McGrath ◽

Sheena McHugh ◽

Patricia M. Kearney ◽

Elaine Toomey

Keyword(s):

Type 2 Diabetes ◽

Primary Care ◽

Health Care Professionals ◽

Evidence Synthesis ◽

Diabetes Distress ◽

Qualitative Evidence Synthesis ◽

Barriers And Enablers ◽

Data Framework ◽

Qualitative Evidence

Background: Depression and diabetes distress are common in people with type 2 diabetes (T2DM). These conditions are independently associated with poorer T2DM outcomes and increased healthcare utilisation and costs. Questions remain regarding the most appropriate ways of initially detecting depression and diabetes distress in this group. Diabetes guidelines recommend depression screening in primary care for people with T2DM but their implementation in practice is suboptimal. As health care professionals influence detection practices, their perceptions and experiences of these guidelines can improve understanding of aspects of the guidelines that work, and those which are more difficult to implement in practice. This study describes the protocol for a qualitative evidence synthesis of primary care health professionals’ perceived barriers and enablers to screen for and diagnose depression and diabetes distress in people with T2DM. Methods and analysis: Primary qualitative and mixed method studies will be identified using a systematic search of electronic databases and the CLUSTER (Citations, Lead authors, Unpublished materials, Scholar searches, Theories, Early examples, Related projects) approach. We selected ‘best-fit framework synthesis’ as the approach to synthesise primary data using the RETREAT (Review question-Epistemology-Time/Timescale-Resources-Expertise-Audience and purpose-Type of Data) framework. Quality appraisal of primary studies and confidence in the overall review findings will be determined using the CASP (Critical Appraisal Skills Programme) and the GRADE-CERQual (Grading of Recommendations Assessment, Development, and Evaluation Confidence in the Evidence from Reviews of Qualitative research), respectively. Discussion: The planned review will provide the first, single point of reference of the available synthesised qualitative evidence on this topic. It will apply recommended approaches to ensure rigor and robustness of study and contribute meaningfully to understanding of how depression and diabetes distress can be initially detected in people with T2DM. This protocol is awaiting processing by the International Prospective Register of Systematic Reviews (PROSPERO) [ID number 145483].

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Quality of primary care from the patient’s point of view. A systematic review. There is currently no acceptable tool for practice or research purposes.

10.21203/rs.2.14226/v1 ◽

2019 ◽

Author(s):

Jeremy Derriennic ◽

Patrice Nabbe ◽

Marie Barais ◽

Sophie Lalande ◽

Delphine Le Goff ◽

...

Keyword(s):

Systematic Review ◽

Primary Care ◽

Evidence Synthesis ◽

Assessment Tools ◽

Level Of Evidence ◽

Measurement Quality ◽

Cosmin Checklist ◽

Best Evidence Synthesis ◽

Psychometric Quality

Abstract Background To run an inventory of instruments which assess quality of care from the patients’ experiences in primary care, in the context of multi-disciplinary health-care centres and which appraise their measurement quality, taking into account the methodological quality of their validation studies. Method Systematic review using Medline, Pascal, PsycINFO, Google Scholar, Cochrane, Scopus and CAIRN. For each instrument identified, the level of evidence was assessed using the COnsensus-based Standards for the selection of health status Measurement Instruments (COSMIN) checklist; the appraisal of the psychometric quality of the measurement property using three possible quality scores and the best-evidence synthesis based on the number of studies, their methodological and psychometric quality, and the direction and consistency of the results. Details of the subscales used to capture patients’ experiences of primary care were extracted and synthesized by grouping them into 9 dimensions defined by the Institute Of Medicine (IOM). Results 29 articles describing 29 instruments were found. Constructs captured by the assessment tools included illustrated a diversity of conceptualizations of patients’ experiences of primary care. There was no clear consensus across the assessment tools included about what patient experience in primary care ought to measure. There is an overall lack of evidence of their measurement quality, either because validation is missing or because methods are poor. Conclusion Due to the lack of evidence, the choice for the most appropriate instrument is difficult. Improvement and validation of existing instruments, and the use of COSMIN-guidelines could help make evaluations more effective.

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