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. 2016 Apr 21:11:55.
doi: 10.1186/s13012-016-0421-7.

Sustainability of knowledge translation interventions in healthcare decision-making: a scoping review

Andrea C Tricco  1   2 , Huda M Ashoor  1 , Roberta Cardoso  1 , Heather MacDonald  1 , Elise Cogo  1 , Monika Kastner  1   2 , Laure Perrier  3 , Ann McKibbon  4 , Jeremy M Grimshaw  5   6 , Sharon E Straus  7   8
Affiliations

Sustainability of knowledge translation interventions in healthcare decision-making: a scoping review

Andrea C Tricco et al. Implement Sci. .

Abstract

Background: Knowledge translation (KT, also known as research utilization, and sometimes referring to implementation science) is a dynamic and iterative process that includes the synthesis, dissemination, exchange, and ethically sound application of knowledge to improve health. A KT intervention is one which facilitates the uptake of research. The long-term sustainability of KT interventions is unclear. We aimed to characterize KT interventions to manage chronic diseases that have been used for healthcare outcomes beyond 1 year or beyond the termination of initial grant funding.

Methods: We conducted a scoping review by searching MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Campbell from inception until February 2013. We included experimental, quasi-experimental, and observational studies providing information on the sustainability of KT interventions for managing chronic diseases in adults and focusing on end-users including patients, clinicians, public health officials, health service managers, and policy-makers. Articles were screened and abstracted by two reviewers, independently. The data were charted and results described narratively.

Results: We included 62 studies reported in 103 publications (total 260,688 patients) plus 41 companion reports after screening 12,328 titles and abstracts and 464 full-text articles. More than half of the studies were randomized controlled trials (RCTs). The duration of the KT intervention ranged from 61 to 522 weeks. Nine chronic conditions were examined across the studies, such as diabetes (34 %), cardiovascular disease (28 %), and hypertension (16 %). Thirteen KT interventions were reported across the studies. Patient education was the most commonly examined (20 %), followed by self-management (17 %). Most studies (61 %) focused on patient-level outcomes (e.g. disease severity), while 31 % included system-level outcomes (e.g. number of eye examinations), and 8 % used both. The interventions were aimed at the patient (58 %), health system (28 %), and healthcare personnel (14 %) levels.

Conclusions: We found few studies focusing on the sustainability of KT interventions. Most of the included studies focused on patient-level outcomes and patient-level KT interventions. A future systematic review can be conducted of the RCTs to examine the impact of sustainable KT interventions on health outcomes.

Keywords: Adherence; Healthcare utilization; Implementation; Knowledge translation; Long-term; Maintenance; Patient education; Quality improvement; Self-management; Sustainability.

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Figures

Fig. 1
Fig. 1
Study flow. Details the flow of information through the different phases of the review; maps out the number of records identified, included and excluded, and the reasons for their exclusion
Fig. 2
Fig. 2
Word cloud displaying sustainability terminology. The most commonly used terminology in the 103 included studies, with the size of the terms in the word cloud corresponding to the frequency of their use
See this image and copyright information in PMC

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