challenges to the systematic review of sexual health interventions for people with severe mental...
DESCRIPTION
Presentation delivered by Eva Kaltenthaler at HTAi 2014 in Washington D.C. co-authors Abdullah Pandor and Ruth WongTRANSCRIPT
Challenges to the systematic review of sexual health
interventions for people with severe mental illness
Dr Eva KaltenthalerReader in Health Technology AssessmentScHARR, University of Sheffield
Co-authors: Abdullah Pandor, Ruth Wong
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Outline of presentation
• Background
• Issues we encountered
• Some suggestions for future research
Background• People with severe mental illness may
be more likely to engage in high risk sexual behaviour
• At risk of worse sexual health outcomes than the general population
• Rapid systematic review
• Transferability of evidence to the UK setting
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BackgroundHeadline results•13 RCTs studies
•People with mental illness
•All trials in USA
•Insufficient evidence to support or reject interventions
•More details in Abdullah’s presentation
The issues
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Population
Interventions
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• Wide range of interventions: HIV prevention and risk reduction Sexual assertiveness Cognitive behavioural skill building Social skills intervention
• Little detail was provided in the studies regarding the content of interventions, how they were delivered and by whom
Comparators
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Outcomes
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Other important issues
• UK care pathway likely to be very different from that in the USA
• Some of the studies were quite old-how do we combine data from studies from different time periods?
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What can be done differently?
Reporting of studies
• More details regarding intervention components and delivery
• Patient characteristics including diagnosis, co-morbidities etc.
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Some trial recommendations• Patient selection criteria clearly
defined
• Clear descriptions of interventions and comparators
• Reliable and valid outcomes with alternatives to self-reported outcomes
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Reviewing suggestions
• Contact authors for more study details
• Consider other approaches to reviewing such as realist synthesis
• Incorporate other study designs apart from RCTs
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Summary
• Results make it difficult to generalise these findings to the UK setting
• These suggestions may help to ensure that further trials provide more useful information
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Funding Acknowledgement:This project was funded by the National Institute for Health Research HTA (project number 12/74/01)
Department of Health Disclaimer:The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HTA, NIHR, NHS or the Department of Health.
ReferenceKaltenthaler E, Pandor A, Wong R. The effectiveness of sexual health interventions for people with severe mental illness: a systematic review. Health Technol Assess 2014;18(1) http://www.journalslibrary.nihr.ac.uk/hta/volume-18/issue-1
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Thank you!
Email: [email protected]: @evakaltenthalerBooth 7