Reporting and representation of underserved groups in intervention studies for patients with multiple long-term conditions: a systematic review

Author:

Kayani Zara1ORCID,Willis Andrew2,Salisu-Olatunji Shukrat O1ORCID,Jeffers Shavez1,Khunti Kamlesh13,Routen Ash13

Affiliation:

1. Diabetes Research Centre, Leicester General Hospital, University of Leicester, Leicester LE1 7RH, UK

2. HRB Clinical Research Facility & School of Public Health, University College Cork T12 WE28, Ireland

3. NIHR Applied Research Collaboration–East Midlands, University of Leicester, Leicester LE5 4PW, UK

Abstract

Objectives Globally, there is a growing number of people who are living with multiple long-term conditions (MLTCs). Due to complex management needs, it is imperative that research consists of participants who may benefit most from interventions. It is well documented that ethnic minority groups and lower socioeconomic status (SES) groups are at an increased risk of developing MLTCs. Therefore, the aim of this systematic review was to determine the level of reporting and representation of underserved groups (ethnic minority and low SES) in intervention studies addressing MLTCs. Design Systematic review. Four databases including Cochrane Library, MEDLINE, CINAHL and Scopus were searched for intervention studies from North America or Europe published between January 1990 and July 2023. Setting Hospital and community-based interventions. We included interventional studies focusing on improving MLTC-related outcomes. Participants Patients with MLTCs. Main outcome measures Total number of studies reporting on ethnicity and SES. Number and proportion of studies reporting by ethnic/SES group. Results Thirteen studies met the inclusion criteria. Only 4 of 13 studies (31%) recorded and reported ethnicity information. Of these four studies that reported on ethnicity, three studies consisted of primarily White participants. Ethnic minority groups were underrepresented, but one study included a majority of African American participants. Moreover, 12 of 13 studies (92%) reported on SES with income and educational level being the primary measures used. SES representation of higher deprivation groups was varied due to limited data. Conclusions For ethnicity, there was a lack of reporting, and ethnic minority groups were underrepresented in intervention studies. For SES, there was a high level of reporting but the proportion of study samples from across the spectrum of SES varied due to the variety of SES measures used. Findings highlight a need to improve the reporting and representation of ethnic minority groups and provide more detailed information for SES through using consistent measures (e.g. education, income and employment) to accurately determine the distribution of SES groups in intervention studies of people with MLTCs.

Publisher

SAGE Publications

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