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

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          Abstract

          Background

          We completed a scoping review on the barriers and facilitators to use of systematic reviews by health care managers and policy makers, including consideration of format and content, to develop recommendations for systematic review authors and to inform research efforts to develop and test formats for systematic reviews that may optimise their uptake.

          Methods

          We used the Arksey and O’Malley approach for our scoping review. Electronic databases (e.g., MEDLINE, EMBASE, PsycInfo) were searched from inception until September 2014. Any study that identified barriers or facilitators (including format and content features) to uptake of systematic reviews by health care managers and policy makers/analysts was eligible for inclusion. Two reviewers independently screened the literature results and abstracted data from the relevant studies. The identified barriers and facilitators were charted using a barriers and facilitators taxonomy for implementing clinical practice guidelines by clinicians.

          Results

          We identified useful information for authors of systematic reviews to inform their preparation of reviews including providing one-page summaries with key messages, tailored to the relevant audience. Moreover, partnerships between researchers and policy makers/managers to facilitate the conduct and use of systematic reviews should be considered to enhance relevance of reviews and thereby influence uptake.

          Conclusions

          Systematic review authors can consider our results when publishing their systematic reviews. These strategies should be rigorously evaluated to determine impact on use of reviews in decision-making.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s13012-016-0370-1) contains supplementary material, which is available to authorized users.

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          Most cited references52

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          The Many Meanings of Research Utilization

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            Systematic reviews: synthesis of best evidence for clinical decisions.

            Systematic reviews can help practitioners keep abreast of the medical literature by summarizing large bodies of evidence and helping to explain differences among studies on the same question. A systematic review involves the application of scientific strategies, in ways that limit bias, to the assembly, critical appraisal, and synthesis of all relevant studies that address a specific clinical question. A meta-analysis is a type of systematic review that uses statistical methods to combine and summarize the results of several primary studies. Because the review process itself (like any other type of research) is subject to bias, a useful review requires clear reporting of information obtained using rigorous methods. Used increasingly to inform medical decision making, plan future research agendas, and establish clinical policy, systematic reviews may strengthen the link between best research evidence and optimal health care.
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              New directions in evidence-based policy research: a critical analysis of the literature

              Despite 40 years of research into evidence-based policy (EBP) and a continued drive from both policymakers and researchers to increase research uptake in policy, barriers to the use of evidence are persistently identified in the literature. However, it is not clear what explains this persistence – whether they represent real factors, or if they are artefacts of approaches used to study EBP. Based on an updated review, this paper analyses this literature to explain persistent barriers and facilitators. We critically describe the literature in terms of its theoretical underpinnings, definitions of ‘evidence’, methods, and underlying assumptions of research in the field, and aim to illuminate the EBP discourse by comparison with approaches from other fields. Much of the research in this area is theoretically naive, focusing primarily on the uptake of research evidence as opposed to evidence defined more broadly, and privileging academics’ research priorities over those of policymakers. Little empirical data analysing the processes or impact of evidence use in policy is available to inform researchers or decision-makers. EBP research often assumes that policymakers do not use evidence and that more evidence – meaning research evidence – use would benefit policymakers and populations. We argue that these assumptions are unsupported, biasing much of EBP research. The agenda of ‘getting evidence into policy’ has side-lined the empirical description and analysis of how research and policy actually interact in vivo. Rather than asking how research evidence can be made more influential, academics should aim to understand what influences and constitutes policy, and produce more critically and theoretically informed studies of decision-making. We question the main assumptions made by EBP researchers, explore the implications of doing so, and propose new directions for EBP research, and health policy.
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                Author and article information

                Contributors
                triccoa@smh.ca
                cardosor@smh.ca
                thomasso@smh.ca
                sanober@alumni.utoronto.ca
                ssull011@uottawa.ca
                ryan.kealey@mail.utoronto.ca
                bhemmelg@ucalgary.ca
                mathieu.ouimet@pol.ulaval.ca
                mhillmer@rogers.com
                l.perrier@utoronto.ca
                sasha.shepperd@ndph.ox.ac.uk
                416-864-3068 , sharon.straus@utoronto.ca
                Journal
                Implement Sci
                Implement Sci
                Implementation Science : IS
                BioMed Central (London )
                1748-5908
                12 January 2016
                12 January 2016
                2015
                : 11
                Affiliations
                [ ]Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, 209 Victoria Street, East Building, Toronto, ON M5B 1W8 Canada
                [ ]Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7 Canada
                [ ]Department of Mechanical and Industrial Engineering, University of Toronto, 5 King’s College Road, Toronto, ON M5S 3G8 Canada
                [ ]Departments of Medicine and Community Health Sciences, University of Calgary, TRW Building, 3rd Floor, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada
                [ ]Département de science politique, Pavillon Charles-De Koninck, Université Laval, Quebec City, Canada
                [ ]Institute of Health Policy, Management and Evaluation, University of Toronto, Health Sciences Building, 155 College Street, Suite 425, Toronto, ON M5T 3M6 Canada
                [ ]Research, Evaluation, and Analysis Branch, Ontario Ministry of Health and Long-Term Care, 80 Grosvenor Street, Toronto, ON M7A 1R3 Canada
                [ ]Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Rd Campus, Headington, Oxford, Oxfordshire OX3 7LF UK
                [ ]Department of Geriatric Medicine, University of Toronto, 27 Kings College Circle, Toronto, ON M5S 1A1 Canada
                Article
                370
                10.1186/s13012-016-0370-1
                4709874
                26753923
                9f7617c4-249f-4d64-aa9f-4d6b373303c0
                © Tricco et al. 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000024, Canadian Institutes of Health Research (CA);
                Award ID: MOP-133468
                Award Recipient :
                Categories
                Systematic Review
                Custom metadata
                © The Author(s) 2016

                Medicine
                systematic reviews,determinants of knowledge uptake
                Medicine
                systematic reviews, determinants of knowledge uptake

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