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Presentation Description
Institution: The University of Melbourne- Faculty of Medicine, Dentistry and Health Sciences - Victoria, Australia
Introduction: The World Health Organisation Commission on Social Determinants of Health (CSDH) identified six essential social determinants: income, education, occupation, social class, sex, and race/ethnicity. While complex interventions exist for people with advanced chronic respiratory diseases (CRD), it is unclear if SDH are reported when testing these interventions, or how they may impact accessibility engagement and effectiveness within sub-populations.
Aims & Methods: This scoping review aimed to determine if SDH are reported in three different complex interventions for people with advanced CRDs (including chronic obstructive pulmonary disease and interstitial lung disease): pulmonary rehabilitation (PR), singing for lung health (SLH) and multicomponent palliative care interventions (MPCI). Studies were identified from PubMed and from three systematic reviews each examining these interventions. Reporting of SDH was assessed for all studies.
Results: Eight SLH, 35 MPCI and 351 PR studies were included. Sex was the most reported SDH across interventions (PR: n = 331, 94.3%, SLH: n = 6, 75.0% and MPCI: n = 31, 88.6%). Social class was least commonly reported, mentioned by 1 PR study (n = 1, 0.3%). Eighteen PR (5.1%) studies, two SLH (25.0%) and three MPCI (8.6%) studies reported no SDH. Included studies were published from 2000-2022 with reporting in PR progressively increasing. Studies were predominantly from high-income countries (304 PR from 26, six SLH from two and all MPCI from 12).
Conclusion: Reporting of SDH in trials of complex interventions for people with advanced CRD is limited. Consequently, the impact of these social barriers on engagement in clinical trials or whether the complex interventions are universally effective or just effective within certain sub-populations is unclear. Future research, particularly clinical trials, must report SDH to understand in which populations these interventions are effective, who is missing from the current evidence base, and to inform trial recruitment and knowledge implementation strategies.
Presenters
Authors
Authors
Ms Lena Ly - University of Melbourne (St Vincent's Hospital) & Respiratory Research @ The Alfred |Central Clinical School | Monash University , Dr Amy Pascoe - Respiratory Research @ The Alfred |Central Clinical School | Monash University , Prof Jennifer Philip - St Vincent's Hospital & The University of Melbourne , Prof Peter Hudson - Centre for Palliative Care, St Vincent's Hospital & The University of Melbourne , A/Prof Natasha Smallwood - Department of Respiratory & Sleep Medicine, The Alfred Hospital & Respiratory Research @ The Alfred |Central Clinical School | Monash University
