Gava V, Xavier de Araujo F, Sharma S, Abbott JH, Lamb SE, Ribeiro DC. Insufficient structure and reporting of process evaluations of complex interventions for musculoskeletal conditions in randomized controlled trials: a systematic review.
J Clin Epidemiol 2025;
179:111637. [PMID:
39662642 DOI:
10.1016/j.jclinepi.2024.111637]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2024] [Revised: 11/12/2024] [Accepted: 12/03/2024] [Indexed: 12/13/2024]
Abstract
OBJECTIVES
To explore how process evaluation of complex interventions alongside randomized clinical trials (RCTs) in musculoskeletal conditions are conducted.
STUDY DESIGN AND SETTING
Systematic review.
METHODS
We searched the MEDLINE, SCOPUS, CINAHL, PsycINFO, Embase, Web of Science, and Cochrane databases. Studies were included if they reported process evaluation conducted alongside RCTs, within the main report or as separate reports, that assessed process evaluation of RCTs of complex nonsurgical and nonpharmacological interventions for musculoskeletal conditions. We performed a descriptive analysis of the included studies based on process evaluation parameters.
RESULTS
Data were extracted from 61 studies from 17 countries. Our findings showed studies used qualitative, quantitative, and mixed methods for process evaluations, typically reporting within the main RCT. Most studies were conducted in primary care settings. Only a few studies (16%) included a theoretical model to guide their process evaluation. Studies reported reach (8%), patients' and clinicians' perceptions of the interventions (44% and 8%, respectively), treatment fidelity and adherence (52% and 43%, respectively), training of patients and clinicians (eg, workshops, manuals and additional training) (54%), how the integration of process evaluation and outcome evaluation findings was performed (68%), barriers to perform the process evaluation (2%), and the strengths and weaknesses of the process evaluation (65%).
CONCLUSION
Reporting of process evaluations within RCTs is insufficiently reported. Researchers rarely adopted a theoretical model or framework to guide their process evaluation. Studies used a variety of methods to conduct process evaluations. We identified barriers, strengths, and weaknesses of methods used for assessing process evaluation as reported by authors from studies included in this review.
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