Presenting evidence and practice: A visual interactive map of review-level evidence and digital interventions for drug/alcohol misuse available in England

Article type
Authors
Burchett H1, Stansfield C2, Sutcliffe K2, Macdowall W1, Richardson M2, Dick S3, Dickson K2, D'Souza P2, Khouja C4, Kwan I2, Raine G4, Thomas J2
1London School of Hygiene & Tropical Medicine
2EPPI-Centre, UCL Institute of Education, University College London
3University College Cork
4Centre for Reviews & Dissemination, University of York
Abstract
Background
There is high unmet need for interventions to prevent, treat and aide recovery from drug/alcohol misuse. Digital interventions have the potential to help overcome barriers to the supply of, and demand for, such interventions. They can use a variety of strategies such as tracking consumption or counselling, delivered through a range of modes, such as apps, videoconferencing and websites. However it is not known what interventions are available, what evidence exists, or what evidence/practice gaps exist.

Objectives
To develop a visual interactive map that presents the findings to the following research questions:
1. Which types of digital drug/alcohol interventions have been evaluated in systematic reviews?
2. Which types of digital drug/alcohol interventions are currently available in England?

Methods
Public Health England, with the study team, developed a ‘pathway’ of prevention, treatment and recovery as a framework for categorising interventions. The map was populated using screening results of database searches for systematic reviews (RQ1) and available interventions identified through an online survey with drug/alcohol commissioners, providers and intervention developers/evaluators (RQ2). Each systematic review was summarised by extracting synthetic statements and descriptive characteristics; quality was appraised using AMSTAR2. A brief description of each available intervention was written, based on the survey results and information on the intervention’s website. These were checked for accuracy with intervention developers. EPPI-Mapper was used to develop the interactive map.

Results
A visual, interactive online map was developed showing 23 systematic reviews and 33 interventions available in England. The number of available interventions and high, medium and low quality systematic reviews, at each pathway point, is visually depicted. Users click on parts of the map to read more about each review and available intervention.
The map highlights the predominance of reviews and interventions targeting drug/alcohol misuse prevention, particularly interventions offering feedback or tracking consumption. There was a relative lack of research and practice targeting treatment or recovery and, whilst there were peer support, relapse and overdose prevention interventions, no systematic reviews had focused on these.

Conclusions
This map provides a visual, interactive overview of review evidence and available interventions. It highlights gaps in research as well as in practice. Visual maps showing both evidence and practice could help commissioners to identify what interventions exist, as well as what evidence there is for interventions. It could also help developers identify gaps where new interventions are needed, and researchers to identify evidence gaps.

Patient or healthcare consumer involvement: Although healthcare consumers were not involved in this project, an advisory group of potential users of the map (commissioners and service providers) met regularly to shape the work.