Barriers and facilitators to implementing clinical imaging guidelines by healthcare professionals using theoretical domains framework: a mixed-methods systematic review protocol

Objectives: To identify, categorize, and develop an aggregated synthesis of evidence using the theoretical domains framework (TDF) on barriers and facilitators that influence implementation of clinical imaging guidelines (CIGs) by healthcare professionals (HCPs) in diagnostic imaging Methods: The protocol will be guided by the Joanna Briggs Institute Reviewers’ Manual 2014. Methodology for JBI Mixed Methods Systematic Reviews and will adhere to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA-P). Information source will include databases (MEDLINE, EMBASE and The Cochrane Library), internet search (https://www.google.com/scholar), experts’ opinion, professional societies/organizations websites and government bodies strategies/recommendations, and reference lists of included studies. Articles of any study design published in English from 1990 to date, having investigated factors operating as barriers and/or facilitators to the implementation CIGs by HCPs will be eligible. Selecting, appraising, and extracting data from the included studies will be independently performed by at least two reviewers using validated tools and Rayyan – Systematic Review web application. Disagreements will be resolved by consensus and a third reviewer as a tie breaker. The aggregated studies will be synthesized using thematic analysis guided by TDF. Results: Identified barriers will be defined a priori and mapped into 7 TDF domains including knowledge, awareness, effectiveness, time, litigationand financial incentives Conclusion: The results will provide an insight into a theory-based approach to predict behavior-related determinants for implementing CIGs and develop strategies/interventions to target the elicited behaviors. Recommendations will be made if the level of evidence is sufficient Advances in knowledge: Resource-constrained settings that are in the process of adopting CIGs may opt for this strategy to predict in advance likely impediments to achieving the goal of CIG implementation and develop tailored interventions during the planning phase. Systematic review Registration: PROSPERO ID = CRD42020136372 (https://www.crd.york.ac.uk/PROSPERO).

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Barriers and facilitators experienced by patients, carers and healthcare professionals when managing symptoms in infants, children and young people at end-of-life: a mixed methods systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2019-030566 ◽

2019 ◽

Vol 9 (7) ◽

pp. e030566 ◽

Cited By ~ 2

Author(s):

Katie Greenfield ◽

Simone Holley ◽

Daniel Eric Schoth ◽

Emily Harrop ◽

Richard Howard ◽

...

Keyword(s):

Systematic Review ◽

Mixed Methods ◽

Young People ◽

End Of Life ◽

Healthcare Professionals ◽

Assessment Tool ◽

Barriers And Facilitators ◽

Cochrane Library ◽

Synthesis Methods ◽

Children And Young People

IntroductionThis protocol describes the objective and methods of a systematic review of barriers and facilitators experienced by patients, carers and healthcare professionals when managing symptoms in infants, children and young people (ICYP) at end-of-life.Methods and analysisThe Cochrane Library, PROSPERO, CINAHL, MEDLINE, PsycINFO, Web of Science Core Collection, ProQuest Dissertations & Theses Database, Evidence Search and OpenGrey will be electronically searched. Reference screening of relevant articles and inquiries to researchers in the field will be undertaken. Studies will be selected if they apply qualitative, quantitative or mixed-methods designs to explore barriers and facilitators experienced by patients, carers and healthcare professionals when managing symptoms in ICYP at end-of-life.Articles will be screened by title and abstract by one reviewer with a second reviewer assessing 10% of the articles. Both reviewers will read and screen all remaining potentially relevant articles. For included articles, one reviewer will extract study characteristics and one will check this.Both reviewers will undertake independent quality assessments of included studies using established and appropriate checklists including The Critical Appraisal Skills Programme Qualitative Checklist; The evaluative criteria of credibility, transferability, dependability and confirmability; The Quality Assessment Tool for Quantitative Studies, and The Mixed Methods Appraisal Tool. Data synthesis methods will be decided after data extraction and assessment.Ethics and disseminationThis review will inform our understanding of symptom management in ICYP at end-of-life. The findings will be reported in a peer-reviewed journal and presented at conferences. The study raises no ethical issues.PROSPERO registration numberCRD42019124797

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Mapping of modifiable barriers and facilitators of medication adherence in bipolar disorder to the Theoretical Domains Framework: a systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2018-026980 ◽

2019 ◽

Vol 9 (2) ◽

pp. e026980 ◽

Cited By ~ 1

Author(s):

Asta Ratna Prajapati ◽

Alexandra Lelia Dima ◽

Allan B Clark ◽

Claire Gant ◽

Chris Gibbons ◽

...

Keyword(s):

Mental Health ◽

Systematic Review ◽

Bipolar Disorder ◽

Medication Adherence ◽

Mental Health Treatment ◽

Theoretical Domains Framework ◽

Barriers And Facilitators ◽

Primary Data ◽

Cochrane Library ◽

Long Term Treatment

IntroductionPeople with bipolar disorder require long-term treatment but it is estimated that 40% of these people do not adhere to prescribed medication regimens. Non-adherence increases the risk of relapse, hospitalisation and suicide. Some evidence syntheses report barriers to mental health treatment adherence but rarely delineate between modifiable and non-modifiable barriers. They also fail to distinguish between the patients’ perspective and that of other stakeholders such as clinicians despite of their different understanding and priorities about adherence. Facilitators of adherence, which are also important for informing adherence intervention design, are also lacking from syntheses and few syntheses focus on medications for bipolar disorder.This systematic review aims to identify modifiable barriers and facilitators (determinants) of medication adherence in bipolar disorder. We also plan to report determinants of medication adherence from perspectives of patients, carers, healthcare professionals and other third parties. A unique feature of this systematic review in the context of mental health is the use of the Theoretical Domains Framework (TDF) to organise the literature identified determinants of medication adherence.Methods and analysisThe protocol adheres to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols and ENhancing Transparency in REporting the synthesis of Qualitative research (ENTREQ) guidelines. This review will include both qualitative and quantitative primary studies exploring determinants of medication adherence in bipolar disorder. We will search the following databases using a preplanned strategy: CINAHL, Cochrane Library (CENTRAL), Embase, LiLACS, Medline, PsychINFO, PubMed without date restrictions. We will report the quality of included studies. We will use framework synthesis using the TDF as an a priori ‘framework’. We will map the literature identified modifiable determinants to the domains of TDF.Ethics and disseminationEthical approval is not required as primary data will not be collected. The results will be disseminated through a peer-reviewed publication.PROSPERO registration numberCRD42018096306.

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Improving the uptake of systematic reviews: a systematic review of intervention effectiveness and relevance

BMJ Open ◽

10.1136/bmjopen-2014-005834 ◽

2014 ◽

Vol 4 (10) ◽

pp. e005834 ◽

Cited By ~ 22

Author(s):

John Wallace ◽

Charles Byrne ◽

Mike Clarke

Keyword(s):

Systematic Review ◽

Systematic Reviews ◽

Full Range ◽

Barriers And Facilitators ◽

Cochrane Library ◽

Extensive Literature ◽

Randomised Trials ◽

Organisation Of Care ◽

Wide Range ◽

Before And After

ObjectiveLittle is known about the barriers, facilitators and interventions that impact on systematic review uptake. The objective of this study was to identify how uptake of systematic reviews can be improved.Selection criteriaStudies were included if they addressed interventions enhancing the uptake of systematic reviews. Reports in any language were included. All decisionmakers were eligible. Studies could be randomised trials, cluster-randomised trials, controlled-clinical trials and before-and-after studies.Data sourcesWe searched 19 databases including PubMed, EMBASE and The Cochrane Library, covering the full range of publication years from inception to December 2010. Two reviewers independently extracted data and assessed quality according to the Effective Practice and Organisation of Care criteria.Results10 studies from 11 countries, containing 12 interventions met our criteria. Settings included a hospital, a government department and a medical school. Doctors, nurses, mid-wives, patients and programme managers were targeted. Six of the studies were geared to improving knowledge and attitudes while four targeted clinical practice.Synthesis of resultsThree studies of low-to-moderate risk of bias, identified interventions that showed a statistically significant improvement: educational visits, short summaries of systematic reviews and targeted messaging. Promising interventions include e-learning, computer-based learning, inactive workshops, use of knowledge brokers and an e-registry of reviews. Juxtaposing barriers and facilitators alongside the identified interventions, it was clear that the three effective approaches addressed a wide range of barriers and facilitators.DiscussionA limited number of studies were found for inclusion. However, the extensive literature search is one of the strengths of this review.ConclusionsTargeted messaging, educational visits and summaries are recommended to enhance systematic review uptake. Identified promising approaches need to be developed further. New strategies are required to encompass neglected barriers and facilitators. This review addressed effectiveness and also appropriateness of knowledge uptake strategies.

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P04 Barriers and facilitators to medicines adherence in children: a systematic review

Archives of Disease in Childhood ◽

10.1136/archdischild-2020-nppg.13 ◽

2020 ◽

Vol 105 (9) ◽

pp. e7.3-e8

Author(s):

Mohammed Aldosari ◽

Ana Oliveira ◽

Sharon Conroy

Keyword(s):

Systematic Review ◽

Parental Education ◽

Healthcare Professionals ◽

Cochrane Collaboration ◽

Barriers And Facilitators ◽

Cochrane Library ◽

Original Research ◽

List Type ◽

Inclusion Criteria ◽

Good Communication

AimImproving adherence to medicines in children with chronic conditions may lead to significant economic and health benefits.1 To improve adherence, the multifactorial causes of poor adherence should be understood.1 A systematic review for barriers and facilitators to medicines adherence in children was conducted seven years ago.2 We updated this to identify barriers and facilitators to medicines adherence in children reported in the last ten years.MethodA systematic literature search was performed using PubMed, EMBASE, Medline, CINAHL, IPA and Cochrane library databases covering the period November 2008 to March 2019. Inclusion criteria were original research studies identifying barriers and/or facilitators of medicines adherence in children (aged 0–18 years) and included all countries and languages. Exclusion criteria included review articles, editorials, conference papers, reports and studies in adults only. As a reliability measure, 5% of titles and abstracts were assessed independently by a second researcher. Quality assessment was performed on all included studies using the STROBE checklist for observational studies and Cochrane collaboration tools for randomised controlled studies and was checked by a second researcher.ResultsOf 9,360 papers identified by the search, only 172 articles met the inclusion criteria. Most studies were conducted in the US (76), with 11 in the UK, six in Canada and the remaining 79 studies in various countries. Diseases studied included: HIV/AIDS (60), asthma (25), kidney or liver diseases and transplants (18), psychiatric disorders (12), inflammatory bowel disease (10), epilepsy (9) and others (38). Various tools were used to identify barriers and facilitators to medicines adherence. These included 131 studies which used individually designed questionnaires, 32 studies used validated questionnaires and the remaining 9 studies used patients’ medical data. Forgetfulness and fear of side effects were the most common reported barriers to medicines adherence. Others reported barriers to adherence included family conflict, weak patient-provider relationships, stigma and discrimination, drug regimen complexity and lack of support from families. Factors reported to facilitate high rates of adherence included the linking of medicine taking with daily life routines, using reminders to avoid forgetfulness, a higher level of caregivers and parental education and good communication between healthcare professionals, patients and parents.ConclusionThe main findings of this systematic review show that children faced many and varied barriers to medicines adherence with different diseases. Using reminders to avoid forgetfulness and good communication between healthcare professionals, patients and parents were the most common facilitators. To achieve optimal adherence, healthcare providers need to be aware of these barriers and to consider the most appropriate facilitators to encourage patients to take their medicines as prescribed.ReferencesBrown MT, Bussell JK. Medication adherence: WHO cares? Mayo Clin Proc 2011;86:304–14.Elliott RA, Watmough DE, Gray NJ, Conroy S, Lakhanpaul M, Pandya H, et al. Talking about medicines (TABS): a multi-method study to understand reasons for medicines non-adherence in children and young people with chronic illness, and to improve their contribution to managing their medicines. Natl Inst Heal Res 2012; 1–423.

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Effectiveness of the Extension for Community Healthcare Outcomes (ECHO) Model of continuing tele-education and influence of key learning conditions on the development of competencies in healthcare professionals: Protocol for a mixed methods systematic review

10.21203/rs.3.rs-334821/v1 ◽

2021 ◽

Author(s):

Gabrielle Chicoine ◽

José Côté ◽

Jacinthe Pepin ◽

Guillaume Fontaine ◽

Marc-André Maheu-Cadotte ◽

...

Keyword(s):

Systematic Review ◽

Mixed Methods ◽

Systematic Reviews ◽

Healthcare Professionals ◽

Grey Literature ◽

Publication Date ◽

Healthcare Outcomes ◽

Community Healthcare ◽

Learning Conditions ◽

Development Of Competencies

Abstract BackgroundThe Extension for Community Healthcare Outcomes (ECHO) Model of continuing tele-education is an innovative guided-practice model aiming at amplifying healthcare professionals’ competencies in the management of chronic and complex health conditions. While data on the effectiveness of the ECHO Model is increasingly available in the literature, the influence of key learning conditions on the model effectiveness remains unclear. Therefore, the overarching aim of this systematic review is to identify, appraise and synthesize the available quantitative (QUAN) and qualitative (QUAL) evidence regarding the effectiveness of the ECHO Model and the influence of key learning conditions on the development of competencies in healthcare professionals.MethodsThis proposed systematic review will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology for Mixed Methods Systematic Reviews (MMSR) and will follow a convergent segregated approach. A systematic search will be undertaken using QUAN, QUAL and mixed methods (MM) studies of ECHO-affiliated programs identified in five databases. A publication date filter will be applied to find the articles published from 2003 onwards. Sources of unpublished studies and grey literature will be searched as well. Retrieved citations will be screened by two review authors independently. Disagreements will be resolved through discussion until a consensus is reached, or by including a third reviewer. Studies meeting the predefined inclusion criteria will be assessed on methodological quality and the data will be extracted using standardized data extraction forms. Separate QUAN and QUAL synthesis will be performed, and findings will be integrated using a matrix approach for the purpose of comparison and complementarity.DiscussionThis MMSR will fulfill important gaps in the current literature on the ECHO Model, as the first to provide estimates on its effectiveness and consider simultaneously the influence of key learning conditions on the development of competencies in healthcare professionals. As implementations of the ECHO Model greatly vary depending on the context, topic and targeted professional group, a better understanding of the conditions that contribute to competencies’ development in healthcare professionals is crucial to inform the design and implementation of the model.Systematic review registration:This MMSR protocol is pending registration in the International Prospective Register of Ongoing Systematic Reviews PROSPERO (submitted October 21, 2020; ID Number: 197579).

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Barriers and facilitators to discontinuing long-term use of benzodiazepine receptor agonists: a qualitative study using the Theoretical Domains Framework

International Journal of Pharmacy Practice ◽

10.1093/ijpp/riab015.024 ◽

2021 ◽

Vol 29 (Supplement_1) ◽

pp. i20-i20

Author(s):

T Lynch ◽

C Ryan ◽

C Cadogan

Keyword(s):

Systematic Review ◽

Behaviour Change ◽

Healthcare Professionals ◽

Theoretical Domains Framework ◽

Benzodiazepine Receptor ◽

Brief Interventions ◽

Barriers And Facilitators ◽

Withdrawal Symptoms ◽

Structured Interviews

Abstract Introduction Long-term use (>3 months) of benzodiazepine receptor agonists (BZRAs) persists in healthcare settings worldwide despite guidelines recommending short-term use (≤4 weeks). Potential harms of long-term BZRA use include dependence and withdrawal symptoms. A systematic review highlighted that brief interventions targeting long-term BZRA use lacked theoretical underpinning and were often poorly described (1). It is advocated that interventions should be systematically developed and reported, use an appropriate theory-base and involve key stakeholders in their development. Semi-structured interviews based on the Theoretical Domains Framework (TDF) can be used to identify patient-level barriers and facilitators that should be targeted by interventions (2). Aim The aim of this study was to explore the views and experiences of individuals who had previously used BZRAs on a long-term basis through semi-structured interviews and to identify key theoretical domains that acted as barriers and facilitators to discontinuing long-term BZRA use. Methods A multi-strand convenience sampling method was used to recruit participants through community pharmacies, general practices and social media (e.g. Twitter, Instagram). Individuals who had successfully discontinued long-term BZRA use were eligible to participate if they were ≥18 years of age, community dwelling and resident in the Republic of Ireland. Individuals with a: cognitive impairment, history of epilepsy, serious mental illness (e.g. prescribed anti-psychotics) or receiving opioid substitution treatment were excluded. Semi-structured interviews were conducted using a TDF-based topic guide (2). Questions covering each TDF domain were used to explore participants’ perceptions of barriers and facilitators to discontinuing long-term BZRA use. Data were recorded and transcribed verbatim. Transcripts were independently checked for accuracy. Data were analysed using the framework method. Interviews continued until data saturation was achieved. Ethical approval was granted by the RCSI Research Ethics Committee. Results Thirteen patients were interviewed (seven female; median age: 43 years; median duration of use: six years). Key barriers to discontinuing BZRA use were identified under the ‘Emotions’ and ‘Reinforcement’ domains. These included participants’ first-hand experience of withdrawal symptoms and resultant fear towards discontinuation of the medication. ‘Intentions’ and ‘Social influences’ were identified as key theoretical domains that facilitated participants in discontinuing BZRA use. For example, participants described having strong intentions to discontinue BZRA use and discussed the positive influence of healthcare professionals such as community pharmacists in supporting them. Conclusion The study findings indicate that individuals who have successfully discontinued long-term BZRA use often have strong intentions to do so, as well as the support of healthcare professionals. However, challenges to discontinuing BZRA use include withdrawal symptoms and negative emotions towards the discontinuation process. The main strength of this study is that it used the TDF to examine barriers and facilitators to discontinuing long-term BZRA use. A notable limitation was that none of the participants were aged ≥65 years which limits the transferability of the findings. Future work will look to examine the views and experiences of current long-term BZRA users, integrate the findings with this study and map key domains to behaviour change techniques to inform the development of an intervention to reduce long-term BZRA use. References 1. Lynch T, Ryan C, Hughes CM, Presseau J, van Allen ZM, Bradley CP, et al. Brief interventions targeting long-term benzodiazepine and Z-drug use in primary care: a systematic review and meta-analysis. Addiction. 2020;115(9):1618–39. 2. Cane J, O’Connor D, Michie S. Validation of the theoretical domains framework for use in behaviour change and implementation research. Implementation Science. 2012;7(1):37.

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Barriers and Facilitators to HIV Prevention Interventions for Reducing Risky Sexual Behavior Among Youth Worldwide: A Systematic Review

10.21203/rs.3.rs-1125426/v1 ◽

2021 ◽

Author(s):

Fungai Mbengo ◽

Esther Adama ◽

Amanda Towell-Barnard ◽

Arvin Bhana

Keyword(s):

Systematic Review ◽

Sexual Behavior ◽

Mixed Methods ◽

Hiv Prevention ◽

Systematic Reviews ◽

Risky Sexual Behavior ◽

Barriers And Facilitators ◽

Prevention Interventions ◽

Multi Level ◽

Hiv Prevention Interventions

Abstract Background: Interventions aimed at reducing risky sexual behavior is considered an important strategy for averting Human Immunodeficiency Virus (HIV) among youth (15-24 years) who continue to be vulnerable to the disease. Enhancing intervention success requires a comprehensive understanding of the barriers and facilitators to interventions targeting youth. However, there is lack of a systematic review of both quantitative and qualitative studies to comprehensively identity and synthesize barriers and facilitators to HIV prevention interventions for reducing risky sexual behavior among youth worldwide. This review aimed to identify and synthesize barriers and facilitators to HIV prevention interventions for reducing risky sexual behavior among youth globally based on original peer-reviewed studies published in the last decade. Methods: The Joanna Briggs Institute approach for mixed methods systematic reviews and Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were used to guide this review. Seven electronic databases, Cambridge and Oxford journals, Joint United Nations Programme on HIV/AIDS and World Health Organization websites, and reference lists of included studies were searched for eligible articles. Studies that met the inclusion criteria underwent quality appraisal and data extraction. Findings were analyzed using thematic synthesis and underpinned by the Determinant Framework.Results: Overall, eight qualitative studies, four quantitative studies and one mixed methods study were included in the review. Several barriers and facilitators across the five Determinant Framework domains were identified. Most of the barriers fell under the characteristics of the context domain (e.g., gender-biased norms). The next important group of barriers emerged within the characteristics of the end users domain (e.g., fear of relationship breakdown). In terms of facilitators, the majority fell under the characteristics of the context domain (e.g., financial support from family) and characteristics of the end users domain (e.g., fear of pregnancy and sexually transmitted infections). The next common set of facilitators appeared within the characteristics of the strategy of facilitating implementation domain (e.g., implementation of intervention with fidelity).Conclusion: This review identified several multi-level barriers and facilitators to HIV prevention interventions for reducing risky sexual behavior among youth. Multi-level and combination approaches are needed to address these factors and enhance intervention success.

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Factors influencing inappropriate use of antibiotics in outpatient and community settings in China: a mixed-methods systematic review

BMJ Global Health ◽

10.1136/bmjgh-2020-003599 ◽

2020 ◽

Vol 5 (11) ◽

pp. e003599

Author(s):

Leesa Lin ◽

Ruyu Sun ◽

Tingting Yao ◽

Xudong Zhou ◽

Stephan Harbarth

Keyword(s):

Systematic Review ◽

Mixed Methods ◽

Financial Incentives ◽

Mainland China ◽

Antibiotic Use ◽

Easy Access ◽

Cochrane Library ◽

Community Settings ◽

Inappropriate Use ◽

Antibiotic Drug

BackgroundFor decades, antibiotics have been excessively consumed around the world, contributing to increased antimicrobial resistance (AMR) and negatively impacting health outcomes and expenditures. Antibiotic use in China accounts for half of worldwide antibiotic consumption, which mainly takes place in outpatient and community settings, and often unnecessarily for self-limiting community-acquired infections. This study aimed to identify and assess factors of inappropriate use of antibiotics in the Chinese context to inform the development of interventions to mitigate inappropriate consumption in the absence of clinical indications.MethodsWe conducted a mixed-methods systematic review and included empirical studies with original data conducted in mainland China, Hong Kong and Taiwan that investigated factors of antibiotic use in the community including outpatient care among patients, caregivers and prescribers. We searched MEDLINE, EMBASE, the Cochrane Library, PsycINFO, Google Scholar and one Chinese database CNKI (China Knowledge Resource Integrated Database), using a combination of the key terms ‘antibiotic’, ‘antimicrobial’, ‘use’, ‘consumption’, ‘behaviour’, ‘prescribe’ and related syntax for all peer-reviewed publications published before June 2020. Health Belief Model was employed for data synthesis.FindingsFifty-four studies were included in the full-text review: 44 quantitative, 5 qualitative and 5 mixed-methods studies. Despite a high AMR awareness, public perception/misconception of antibiotic efficacy and easy access to antibiotics for self-limiting conditions drive inappropriate demand and use in the community including primary care setting. Providers’ prescribing behaviours are influenced by financial incentives, lack of diagnostic capacity and concerns over complications.ConclusionsInappropriate outpatient and community antibiotic use is influenced by non-biomedical factors at the individual, community, health system and societal levels in mainland China, contributing to a high antibiotic use rate. This study calls for context-tailored One Health interventions, restrictive antibiotic drug policy and multifaceted antibiotic stewardship programmes that simultaneously address drivers of inappropriate use from both the supply-side and demand-side within and beyond clinical settings.PROSPERO registration numberCRD42019139591.

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Appraisal of systematic reviews on interventions for postpartum depression: systematic review

BMC Pregnancy and Childbirth ◽

10.1186/s12884-020-03496-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ryan Chow ◽

Eileen Huang ◽

Allen Li ◽

Sophie Li ◽

Sarah Y. Fu ◽

...

Keyword(s):

Systematic Review ◽

Postpartum Depression ◽

Systematic Reviews ◽

Methodological Quality ◽

A Priori ◽

Behavioural Therapy ◽

Therapeutic Interventions ◽

Current Evidence ◽

Cochrane Library ◽

Measurement Tool

Abstract Background Postpartum depression (PPD) is a highly prevalent mental health problem that affects parental health with implications for child health in infancy, childhood, adolescence and beyond. The primary aim of this study was to critically appraise available systematic reviews describing interventions for PPD. The secondary aim was to evaluate the methodological quality of the included systematic reviews and their conclusions. Methods An electronic database search of MEDLINE, Embase, and the Cochrane Library from 2000 to 2020 was conducted to identify systematic reviews that examined an intervention for PPD. A Measurement Tool to Assess Systematic Reviews was utilized to independently score each included systematic review which was then critically appraised to better define the most effective therapeutic options for PPD. Results Of the 842 studies identified, 83 met the a priori criteria for inclusion. Based on the systematic reviews with the highest methodological quality, we found that use of antidepressants and telemedicine were the most effective treatments for PPD. Symptoms of PPD were also improved by traditional herbal medicine and aromatherapy. Current evidence for physical exercise and cognitive behavioural therapy in treating PPD remains equivocal. A significant, but weak relationship between AMSTAR score and journal impact factor was observed (p = 0.03, r = 0.24; 95% CI, 0.02 to 0.43) whilst no relationship was found between the number of total citations (p = 0.27, r = 0.12; 95% CI, − 0.09 to 0.34), or source of funding (p = 0.19). Conclusion Overall the systematic reviews on interventions for PPD are of low-moderate quality and are not improving over time. Antidepressants and telemedicine were the most effective therapeutic interventions for PPD treatment.

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