Do Cochrane Reviews evaluate healthcare interventions for immigrants and refugees?

Article type
Authors
Imai RY1, Tonsig GK1, Pacheco RL2, Latorraca CO1, Riera R1
1Escola Paulista de Medicina, Universidade Federal de São Paulo
2Centro Universitario Sao Camilo and Escola Paulista de Medicina, Universidade Federal de São Paulo
Abstract
Background: discussions around issues related to immigrants and refugees are emerging more frequently, mainly because of the migratory movements in recent years years and their social and cultural repercussions. According to the United Nations High Commissioner for Refugees, the number of moving people increased from around 40 million to 68.5 millions in 10 years [1]. This scenario exposes the vulnerability of this population and the health particularities associated with people in movement.

Objectives: to investigate and characterize Cochrane Reviews (CRs) and Protocols that considered or planned to include immigrants and/or refugees as the main population or subgroup of interest.

Methods: we ran a sensitive search (Table 1) in the Cochrane Database of Systematic Reviews to retrieve all relevant reviews and protocols that included immigrants and/or refugees as the main population or subgroup of interest. Two independent researchers performed the selection and data extraction process, and a third review researcher resolved disagreements. The following data were extracted from included reviews/protocols: publication year, number of included randomized controlled trials (RCT) and participants, update status, and authors' countries.

Results: the search strategy retrieved 98 records, but we included only seven CRs (0.0879% of all CRs), involving 20 immigrant- and/or refugee-related RCTs (4441 participants, Table 2), plus one protocol. The publication year of the first version ranged from 1999 to 2018. Countries from all continents were represented within the author team from included CRs and protocols. None of the CRs had been updated in the two previous years.

Conclusions: the health vulnerability of immigrants and refugees increases the need for RCTs that address the particularities of these populations. We found few Cochrane Reviews and Protocols that considered immigrants and refugees as the main population of interest, despite the increasing number of this population.

Patient or healthcare consumer involvement: considering that 68.5 million people are immigrants or refugees, it is important to develop Cochrane Reviews to assess interventions that promote the health and increase the quality of life of this population.