Abstract
IntroductionHealthcare organisations recognise the moral imperative to address inequalities in health outcomes but often lack an understanding of which types of interventions are likely to reduce them. This realist review will examine the existing evidence on the types of interventions or aspects of routine care in general practice that are likely to decrease or increase health inequalities (ie, inequality-generating interventions) across cardiovascular disease, cancer, diabetes and chronic obstructive pulmonary disease.Methods and analysisOur realist review will follow Pawson’s five iterative stages. We will start by developing an initial programme theory based on existing theories and discussions with stakeholders. To navigate the large volume of literature, we will access the primary studies through the identification of published systematic reviews of interventions delivered in general practice across the four key conditions. We will examine the primary studies included within each systematic review to identify those reporting on inequalities across PROGRESS-Plus categories. We will collect data on a range of clinical outcomes including prevention, diagnosis, follow-up and treatment. The data will be synthesised using a realist logic of analysis. The findings will be a description and explanation of the general practice interventions which are likely to increase or decrease inequalities across the major conditions.Ethics and disseminationEthics approval is not required because this study does not include any primary research. The findings will be integrated into a series of guiding principles and a toolkit for healthcare organisations to reduce health inequalities. Findings will be disseminated through peer-reviewed publications, conference presentations and user-friendly summaries.PROSPERO registration numberCRD42020217871.
Funder
National Institute for Health Research
Health Services and Delivery Research Programme
Reference33 articles.
1. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017
2. Mackenbach JP . Health inequalities - Persistence and change in European welfare states. Oxford University Press, 2019.
3. The COVID-19 pandemic and health inequalities;Bambra;J Epidemiol Community Health,2020
4. Institute for Health Equity . Social inequalities in the leading causes of early death a life course approach, 2015. Available: http://www.instituteofhealthequity.org/resources-reports/social-inequalities-in-the-leading-causes-of-early-death-a-life-course-approach/social-inequalities-in-the-leading-causes-of-early-death-a-life-course-approach.pdf [Accessed 9 Jul 2019].
5. Office for National Statistics . Health state life expectancies by national deprivation deciles, England and Wales - Office for National Statistics, 2019. Available: https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthinequalities/bulletins/healthstatelifeexpectanciesbyindexofmultipledeprivationimd/2015to2017 [Accessed 9 Jul 2019].
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