Abstract
BackgroundAn epidemic of health disorders can be triggered by a collective manifestation of inappropriate behaviors, usually systematically fueled by non-medical factors at the individual and/or societal levels. This study aimed to (1) landscape and assess the evidence on interventions that reduce inappropriate demand of medical resources (medicines or procedures) by triggering behavioral change among healthcare consumers, (2) map out intervention components that have been tried and tested, and (3) identify the “active ingredients” of behavior change interventions that were proven to be effective in containing epidemics of inappropriate use of medical resources.MethodsFor this systematic review, we searched MEDLINE, EMBASE, the Cochrane Library, and PsychINFO from the databases’ inceptions to May 2019, without language restrictions, for behavioral intervention studies. Interventions had to be empirically evaluated with a control group that demonstrated whether the effects of the campaign extended beyond trends occurring in the absence of the intervention. Outcomes of interest were reductions in inappropriate or non-essential use of medicines and/or medical procedures for clinical conditions that do not require them. Two reviewers independently screened titles, abstracts, and full text for inclusion and extracted data on study characteristics (e.g., study design), intervention development, implementation strategies, and effect size. Data extraction sheets were based on the checklist from the Cochrane Handbook for Systematic Reviews.ResultsForty-three studies were included. The behavior change technique taxonomy v1 (BCTTv1), which contains 93 behavioral change techniques (BCTs), was used to characterize components of the interventions reported in the included studies. Of the 93 BCTs, 15 (16%) were identified within the descriptions of the selected studies targeting healthcare consumers. Interventions consisting of education messages, recommended behavior alternatives, and a supporting environment that incentivizes or encourages the adoption of a new behavior were more likely to be successful.ConclusionsThere is a continued tendency in research reporting that mainly stresses the effectiveness of interventions rather than the process of identifying and developing key components and the parameters within which they operate. Reporting “negative results” is likely as critical as reporting “active ingredients” and positive findings for implementation science. This review calls for a standardized approach to report intervention studies.Trial registrationPROSPERO registration number CRD42019139537
Highlights
An epidemic of health disorders can be triggered by a collective manifestation of inappropriate behaviors, usually systematically fueled by non-medical factors at the individual and/or societal levels
Epidemics, which traditionally refer to a widespread occurrence of an infectious disease in a community at a particular time, have in recent years been used to describe large-scale public health issues caused by a shared pattern of human behaviors that impact public health and well-being
When medicines or medical procedures are used for conditions for which they should not be used, they are deemed as inappropriate use of medical interventions
Summary
An epidemic of health disorders can be triggered by a collective manifestation of inappropriate behaviors, usually systematically fueled by non-medical factors at the individual and/or societal levels. An epidemic of health disorders can be triggered by organisms that cause communicable diseases, such as bacteria, viruses, fungi, or parasites, and by a collective manifestation of inappropriate behaviors, usually systematically fueled by non-clinical factors at the individual and/or societal levels. There have been experiments with programs designed to address factors driving the epidemics of inappropriate use of medical interventions These countermeasures are often non-clinical behavioral change interventions targeting physicians and pharmacists as a point-of-entry for interventions and are designed to improve clinical practices and policies that restrict unnecessary dispensing [5, 6]. The lack of evidence in the development of and evaluation of the impact of these interventions, especially in low- and middle-income countries (LMICs), complicates replication efforts [16, 17, 20]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
