Health Service Use among adults with Cerebral Palsy: A mixed method systematic review protocol

Abstract

Introduction: Cerebral palsy (CP) is a childhood neurodisability that primarily results in motor impairments and activity limitations. Most children with CP survive well into adulthood. As adults, people with CP experience secondary conditions in addition to ongoing health issues from childhood. However, health service use among adults with CP remains unclear. This mixed methods review aims to identify, appraise and synthesize the available literature on health service use among adults with CP. Methods: The mixed method systematic review will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology. A systematic search of Medline (Ovid), CINAHL, EMBASE, PsychINFO and Cochrane library from inception will be conducted. Quantitative observational studies, qualitative studies, and mixed method studies examining health service use among adults with CP (≥ 18 years) will be included. Outcomes of interest are the proportion of adults using health services, the frequency of health service use and the experiences and perceptions of health services for adults with CP. Two reviewers will independently screen titles, abstracts and full texts, extract data, and assess the quality of included studies using instruments from the JBI. Where possible a pooled analysis and aggregation of findings will be performed for quantitative and qualitative data, respectively, and GRADE/GRADE-CerQual employed. The quantitative and qualitative findings will be integrated using triangulation approach at the synthesis stage. A narrative synthesis will be done where this is not possible. Implications: This review will direct research efforts and inform service provision, by providing greater insights of health services used among adults with CP.