Article type
Abstract
"BACKGROUND Harm reduction aims to minimise the negative consequences associated to drug use. Grounded in justice and human rights, it focuses on person centredness, positive change and equity. It is commitment to use evidence to strengthen its impact on individual and community health, and frequently is required to inform decisions related to personal views, accessibility or diversity. Therefore, reviews synthesizing qualitative research are especially useful in this field, but there is uncertainty regarding how these reviews are conducted and their adherence to formal methodological guidance.
OBJECTIVES To describe the methodological characteristics of qualitative research synthesis conducted in the field of harm reduction and their opportunities for improvement.
METHODS We conducted a scoping review according to a prespecified protocol. We searched qualitative evidence synthesis (QES) in the field of harm reduction (PubMed (June 2023)). One reviewer screened the search results for the eligible reviews, and two reviewers classified independently their relevance according to harm reduction priorities. We extracted data to describe the themes and key methodological features of the included reviews. We synthesized our findings narratively, and mapped deductively the main methodological limitations based on Cochrane QIMG guidance for QES.
RESULTS From 45 included QES, 25 had an interpretative purpose, but only few disclosed researchers' reflexivity. Almost half were conducted according to a pre-specified protocol, but only nine formulated framed questions (e.g., SPIDER/SPICE)). One-third did not report the methodology used (seven of them used the PRISMA statement). The majority of reviews analysed data through thematic analysis or meta-ethnography frameworks. Nearly all appraised their included studies, primarily using CASP, but the use of CERQual was anecdotical (four QES). Only 11 QES reported their findings according to appropriate guidelines, with 16 using PRISMA.
CONCLUSIONS Evidence syntheses provide context to issues with a direct societal impact and frequently bring knowledge to questions centred in the views of people who use drugs (PWUD). QES play an important role in informing decisions in harm reduction, but ensuring their rigorous conduct is essential for results that are reliable and relevant for PWUD. Effective training and dissemination of methodological guidance can ensure the production of such reliable evidence."
OBJECTIVES To describe the methodological characteristics of qualitative research synthesis conducted in the field of harm reduction and their opportunities for improvement.
METHODS We conducted a scoping review according to a prespecified protocol. We searched qualitative evidence synthesis (QES) in the field of harm reduction (PubMed (June 2023)). One reviewer screened the search results for the eligible reviews, and two reviewers classified independently their relevance according to harm reduction priorities. We extracted data to describe the themes and key methodological features of the included reviews. We synthesized our findings narratively, and mapped deductively the main methodological limitations based on Cochrane QIMG guidance for QES.
RESULTS From 45 included QES, 25 had an interpretative purpose, but only few disclosed researchers' reflexivity. Almost half were conducted according to a pre-specified protocol, but only nine formulated framed questions (e.g., SPIDER/SPICE)). One-third did not report the methodology used (seven of them used the PRISMA statement). The majority of reviews analysed data through thematic analysis or meta-ethnography frameworks. Nearly all appraised their included studies, primarily using CASP, but the use of CERQual was anecdotical (four QES). Only 11 QES reported their findings according to appropriate guidelines, with 16 using PRISMA.
CONCLUSIONS Evidence syntheses provide context to issues with a direct societal impact and frequently bring knowledge to questions centred in the views of people who use drugs (PWUD). QES play an important role in informing decisions in harm reduction, but ensuring their rigorous conduct is essential for results that are reliable and relevant for PWUD. Effective training and dissemination of methodological guidance can ensure the production of such reliable evidence."