The use of Cochrane reviews in an African first-aid and prevention guideline for lay people

Article type
Authors
Borra V1, Avau B2, Van Remoortel H1, Vande veegaete A1, Laermans J1, De Buck E3, Vandekerckhove P4
1Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen
2Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium; Cochrane Belgium, Centre for Evidence-Based Medicine, Leuven
3Centre for Evidence-Based Practice, Belgian Red Cross, Mechelen, Belgium; Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven, Leuven
4Belgian Red Cross, Mechelen, Belgium; Department of Public Health and Primary Care, Faculty of Medicine, KU Leuven, Leuven, Belgium; Faculty of Medicine, University of Ghent, Ghent
Abstract
Background: The Belgian Red Cross develops evidence-based first aid and prevention guidelines for lay people, not only for the Belgian context, but also for other countries, such as India, Nepal and sub-Saharan Africa. A first-aid and prevention manual for sub-Saharan Africa was developed in 2011 and updated in 2016.

Objectives: Cochrane intends to make healthcare decisions better by summarising the best evidence from research into Cochrane reviews, to help informed decision making. The aim of this study was to investigate whether Cochrane reviews are useful for the development of African first-aid and prevention guidelines for lay people.

Methods: A total of 114 PICO questions for 20 topics were addressed for the update of the African first-aid and prevention guidelines. Fifty of these questions (44%) were context-specific interventions for sub-Saharan Africa (e.g. honey as treatment for burns). Search strategies were developed for MEDLINE, Embase and the Cochrane Library, to find systematic reviews and individual studies.

Results: Evidence was found for 86 PICOs (75%), of which 29 PICOs (34%, 9 PICOs on first aid and 20 on prevention) were supported by Cochrane systematic reviews (SRs). Topics best supported by Cochrane SRs were ‘injuries to muscles, joints or limbs’ (71% of the PICOs for this topic were supported by a Cochrane review), ‘diarrhoea’ (45%) and ‘emergency childbirth’ (43%). Nineteen of the 29 PICOs were up-to-date (less than 5 years old) or are considered stable, for 10 PICOs the Cochrane review was outdated (more than 5 years old). For 9 of the 20 topics, no Cochrane SRs were available. These topics include ‘stroke’, ‘choking’, ‘chest discomfort’, ‘severe bleeding and shock’, ‘stings and bites’, ‘eye injuries’, ‘fainting’, ‘fits’ and ‘rash’.

Conclusions: Although some topics are fairly covered by Cochrane SRs, we must conclude that for guidelines aimed at lay people there is still a large gap for which no Cochrane SRs are available, or Cochrane SRs are out-of-date. A closer collaboration between Cochrane review groups and guideline developers would be relevant in order to enhance uptake of Cochrane SRs into practice.