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Effective Health Care Program

Systematic Reviews of Complex Multicomponent Health Care Interventions

White Paper

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Structured Abstract

Background

The purpose of this report is to outline approaches to address the challenges of conducting systematic reviews of complex multicomponent health care interventions.

Methods

We performed a literature scan and conducted semi-structured interviews with international experts who conduct research or systematic reviews of complex multicomponent interventions, or organizational leaders who implement complex multicomponent interventions in health care.

Results

Challenges identified include: a lack of consistent terminology for such interventions (e.g., complex; multicomponent; multidimensional; multifactorial); a wide range of approaches used to frame the review, from grouping interventions by common features to using more theoretical approaches; decisions regarding whether and how to quantitatively analyze the interventions, from more holistic to individual component analytic approaches; and incomplete and inconsistent reporting in primary and secondary studies of those elements critical to understanding the success and impact of such interventions, such as the methods used to implement the intervention, and the context in which it is implemented.

Conclusions

We provided a framework to understand the spectrum of conceptual and analytic approaches and an initial list of critical reporting elements for primary and secondary studies of multicomponent interventions. This information will help reviewers understand the options and tradeoffs available for such reviews.