Evidence synthesis methodologies used for questions relating to barriers and/or enablers in health care: a methodological scoping review

Session Type
Overviews of reviews and scoping reviews
Stern C1, Lizarondo L1, Pollock D2, Whitehorn A1, Davis E3, Gohil D4, Puljak L5, Munn Z2, Kirkpatrick P6, Loureiro R7, Cardoso D7, Borges dos Santos K8, Habibi N1, Jia R1, Pieper D9, Carrier J10, Loveday H11
1JBI, University of Adelaide, Australia
2HESRI, University of Adelaide, Australia
3Adelaide Health Simulation, University of Adelaide, Australia
4University of Adelaide, Australia
5Catholic University of Croatia, Croatia
6School of Nursing, Midwifery and Paramedic Practice, Robert Gordon University, Scotland
7Nursing School of Coimbra, Portugal
8Universidade de São Paulo, Brazil
9Institute for Health Services and Health Systems Research, Germany
10College of Biomedical and Life Sciences, Cardiff University, Wales
11College of Nursing, Midwifery and Healthcare, University of West London, UK

Background: Questions related to identifying factors that act as barriers or that enable (i.e. support) best practice in healthcare are a popular form of primary research to understand the evidence-practice gap. Currently there is no consensus regarding which methodological approach to use when undertaking an evidence synthesis relating to barriers and/or enablers in healthcare, nor the methods for synthesizing results. Further investigation is needed to overcome this challenge and assist in informing decisions for patient/service users.
Objectives:To determine the methodological processes used in barrier and/or enabler reviews to inform the development of future guidance for the evidence synthesis of barrier and/or enabler studies.
Methods: A methodological scoping review based on an apriori protocol and following JBI guidance was conducted. All forms of evidence syntheses (excluding literature reviews and umbrella reviews) that described the methods used and were related to any level of the health system were eligible, including consumers of healthcare. In 2022 PubMed, Embase, CINAHL, PsycINFO, Cochrane, JBI and EPPI-Centre databases were searched and records were screened independently in duplicate. A customised data extraction form was developed and results mapped and synthesized narratively.
Results: From over 24,000 records screened, 798 reviews were eligible for inclusion. A range of methodologies, including but not limited to systematic reviews; integrative reviews, scoping reviews, mixed methods systematic reviews and rapid reviews were used in the included studies. Synthesis methods varied and included approaches such as narrative synthesis, descriptive analysis, qualitative synthesis, meta-analysis and framework synthesis. In some reviews there were incongruencies between the study aims, stated methodologies and the methods used to undertake the review as well as the conduct and reporting guidance followed.
Conclusions: This review identified that a range of methodologies and methods are used to synthesize questions relating to barriers and/or enablers in the context of health care. Issues were identified relating to misalignment between guidance followed and methodologies and methods used.
Patient, public and/or healthcare consumer involvement: The results of this review are of importance to patients/service users as syntheses of barriers and/or enablers are often undertaken to inform patient care and service improvement.