Background: Self-care describes how people assess, treat and manage their own health. With increasing and unsustainable burdens on healthcare systems, facilitating self-care of long-term conditions is increasing in priority. Cochrane reviews cover a wide range of health interventions but it is not clear to what extent Cochrane reviews inform and support self-care for common, long-term health conditions.
Objectives: To develop a model/pilot a process for assessing the potential for Cochrane reviews to inform self-care and to identify possible ‘review’ gaps.
Methods: For this pilot, we focused on depression and anxiety, and screened all records from the Cochrane Common Mental Disorders Review Group to identify relevant reviews. We defined self-care as interventions that could be selected and applied without the assistance of a practitioner. Two authors independently screened titles and abstracts and then the full text of all potentially relevant reviews, with disagreements resolved by discussion. We extracted data into a predefined extraction form: review details, population, intervention, main comparison(s), numbers of studies and participants, meta-analyses, conclusions, relevance to self-care. The list of interventions was compared with surveys of use of self-care approaches.
Results: 234 records were retrieved and 186 were excluded at title/abstract stage. After full-text screening, 20 records were excluded, 7 (protocols) remained unclear and 21 were included; 15 focused on depression, 5 on anxiety and 1 on both. The interventions were mainly herb/diet supplements, psychological and mind-body based. Ten therapies were judged effective or promising with small effect sizes in most cases but content and phrasing of conclusions varied considerably. Compared with self-care treatments used in practice, only a small number were addressed in Cochrane reviews.
Conclusions: This pilot has revealed the potential of Cochrane reviews to inform self-care and the variation in presentation of conclusions which would make this a challenge. A number of ‘review’ gaps were identified. The extension of this process to self-care for other conditions will be discussed.