Effectiveness of knowledge translation tools addressing multiple high-burden chronic diseases affecting older adults: protocol for a systematic review alongside a realist review

Abstract

IntroductionThe burden of chronic disease is a global phenomenon, particularly among people aged 65 years and older. More than half of older adults have more than one chronic disease and their care is not optimal. Chronic disease management (CDM) tools have the potential to meet this challenge but they are primarily focused on a single disease, which fails to address the growing number of seniors with multiple chronic conditions.Methods and analysisWe will conduct a systematic review alongside a realist review to identify effective CDM tools that integrate one or more high-burden chronic diseases affecting older adults and to better understand for whom, under what circumstances, how and why they produce their outcomes. We will search MEDLINE, EMBASE, CINAHL, AgeLine and the Cochrane Library for experimental, quasi-experimental, observational and qualitative studies in any language investigating CDM tools that facilitate optimal disease management in one or more high-burden chronic diseases affecting adults aged ≥65 years. Study selection will involve calibration of reviewers to ensure reliability of screening and duplicate assessment of articles. Data abstraction and risk of bias assessment will also be performed independently. Analysis will include descriptive summaries of study and appraisal characteristics, effectiveness of each CDM tool (meta-analysis if appropriate); and a realist programme theory will be developed and refined to explain the outcome patterns within the included studies.Ethics and disseminationEthics approval is not required for this study. We anticipate that our findings, pertaining to gaps in care across high-burden chronic diseases affecting seniors and highlighting specific areas that may require more research, will be of interest to a wide range of knowledge users and stakeholders. We will publish and present our findings widely, and also plan more active dissemination strategies such as workshops with our key stakeholders.Trial registration numberOur protocol is registered with PROSPERO (registration number CRD42014014489).

Knowledge translation for realist reviews: a participatory approach for a review on scaling up complex interventions

“…a realist approach to knowledge synthesis that emphasises producing a time-sensitive product responsive to policy-makers’ information needs). Specific types of KT activities identified in the papers included healthcare planning frameworks and tools to support decision-makers [ 40 , 41 ], publications for academic and lay audiences [ 41 ], conference presentations [ 41 ], tailored workshops and presentations for knowledge users (e.g. policy-makers) [ 41 , 42 ], and knowledge brokering to understand policy and academic perspectives and develop recommendations that are sensitive to local contexts [ 43 ].…”

“…The included papers articulated the aim of the KT strategy in different ways. Two papers indicated that their KT efforts would help them achieve goals related to the purpose of the research [ 41 , 43 ]. One paper was more specific in how their findings would be used, stating that findings would inform the development of a new intervention [ 40 ].…”

Effectiveness of interventions for managing multiple high-burden chronic diseases in older adults: a systematic review and meta-analysis

“…Our systematic review protocol has been published 15 and is registered with PROSPERO (the international prospective register of systematic reviews): registration no. CRD42014014489.…”

On the development and application of EMMIE: insights from the What Works Centre for Crime Reduction

“…This is a high bar to reach, and we will argue that the systematic reviews that we have reviewed have seldom achieved this, nor have many others in the crime prevention literature. A movement towards incorporating realist principles in both primary evaluations and evidence syntheses has been seen across the policy landscape and is apparent, for example, in public health research as well as crime reduction (see, for example, Berwick 2008;Creswell 2014;Davidoff 2009;Best et al 2012;Kastner et al 2015).…”