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Is there a potential of umbrella reviews to inform guideline development?

Date and Location

Session: 

P2.054

Date

Saturday 21 September 2013 - 10:30 - 12:00

Location

Presenting author and contact person

Presenting author

Trudy Bekkering

Contact person

Trudy Bekkering
Abstract text
Background: A best practice guideline on the prevention of substance misuse in adolescents was developed in Belgium, using the ADAPTE methodology. A comprehensive search revealed three high-quality relevant guidelines. However, several clinical questions formulated by the stakeholders involved could not be answered by these guidelines. As multiple systematic reviews were available, we conducted an umbrella review in an attempt to fill in the gaps. Objectives: To summarize the evidence on programs to prevent adolescent substance misuse in order to inform the guideline adaptation process. Methods: We searched seven electronic databases, websites and checked reference lists of relevant articles for reviews on the effectiveness of school-based, family-based, community-based or multicomponent prevention. We also assessed who should deliver the program, what content and delivery method would be best and which groups should be targeted. Systematic reviews that met our predefined inclusion criteria were critically appraised using the AMSTAR instrument. Due to the heterogeneity of outcome measures and the way these were reported, the findings were synthesized using a vote-counting approach. Results: We found 22 reviews reporting on several populations and a wide range of interventions and outcomes. Many reviews also lacked detail in the reporting of process and implementation related aspects of the prevention programs which hampered overall conclusions of which programs are effective, who should deliver the programs, what content and delivery method is best and which subgroups should be targeted. Conclusions: None of the outstanding clinical questions could be answered by the results of the umbrella review. This may be due to the heterogeneity in population, interventions and outcomes and the low level of detail of reporting. The potential of umbrella reviews to adapt guidelines need to be investigated for topics with a higher level of standardization in interventions and outcome measures.