Is Chilean clinical research on depression aligned with core outcome sets?

Article type
Authors
Sánchez A1, Bracchiglione J2, Madrid E2, Meza N2
1School of Medicine, Universidad de Santiago de Chile, Chile; Pharmacy Unit, Libertador General Bernardo O'Higgins Regional Hospital, Rancagua, Chile
2Interdisciplinary Centre For Health Studies (ciesal), Universidad De Valparaíso, Viña Del Mar, Chile, Chile; Iberoamerican Cochrane Centre, Institut de Recerca Sant Pau (IR Sant Pau), CIBERESP, Barcelona, Spain
Abstract
Background: Depression in adults is a prioritised disease in Chile, as it represents the third most burdensome health condition, and, therefore, has a universally guaranteed financial coverage by the health system. Public research funding should be allocated to assess priority health conditions and patient-centred outcomes. Currently, it is unclear whether local clinical research agenda is aligned with the health system priorities, nor if it assesses outcomes that are relevant for clinical practice.
Objective: To estimate the proportion of Chilean clinical research on depression assessing outcomes prioritised in core outcome sets (COS), according to source of funding.
Methods: As part of a broader scoping review, we identified all Chilean clinical research on depression, since 2000 onwards. We defined a research as Chilean if it had at least one author with a Chilean affiliation, or if it included Chilean population. We extracted the funding source and the outcomes assessed by each of the retrieved Chilean studies. Then, we identified clinically relevant outcomes for depression according to two criteria: i) Those prioritised by a COS from the COMET (Core Outcome Measures in Effectiveness Trials) initiative; and ii) those previously prioritised by local clinical practice guidelines for depression. Lastly, we estimated the proportion of outcomes assessed in local research with those clinically relevant for depression, according to funding sources.
Results: We identified 21 studies assessing interventions for depression, of which 14 received public funding, six received non-public funding and one did not report the source of funding. Among the publicly-funded studies, three (21.4%) did not report any clinically relevant outcome, while 11 (78.5%) assessed at least one outcome belonging to the COS for depression, and 3 (21.4%) assessed at least one outcome prioritised by local clinical practice guidelines. Among the six studies non-publicly funded, four had at least one clinically relevant outcome.
Conclusion: Although most of the local clinical research on depression is publicly-funded and reports clinically relevant outcomes, there is still room for improvement, as nearly one out of five studies are not considering relevant outcomes. We urge policy-makers to improve the research agenda to make clinical research better aligned with clinical practice.