gms | German Medical Science

Background: There is an increasing focus on inequity in healthcare and health outcomes. Early awareness of potential sources of inequity in access to and outcomes from innovative health technologies can support system preparedness and allow implementation of mitigations. They may also be used to improve research inclusion. We explored methods used to integrate equality and equity into horizon scanning for healthcare innovations; acceptability, polypharmacy, and comorbidity were considered as closely related constructs which are linked to inequity.

Methods: A rapid scoping review followed Joanna Briggs Institute (JBI) guidelines to identify relevant methodologies for integrating equity into horizon scanning. Searches were conducted in MEDLINE, Embase, ProQuest, and WHO Global Index Medicus up to May 24, 2024. Studies were eligible if they presented methodologies for integrating equity and equality considerations into horizon scanning in health and care. Primary outcomes related to equity or equality, and secondary outcomes addressed acceptability, polypharmacy, and comorbidity. Data were extracted on study characteristics, equity frameworks, and the integration of equity-related factors, including socioeconomic status, gender, and geographic location. A narrative synthesis was used to present the findings.

Results: 951 records were identified but only three studies were included. The studies used varied horizon scanning methods, including scenario-building and foresight methodologies, and spanned multiple healthcare contexts such as precision oncology and complex paediatric care. Each study incorporated equity/equality by addressing the impact of emerging innovations on vulnerable populations. Acceptability was found to be crucial for equitable implementation, particularly in precision oncology, while polypharmacy and comorbidity were highlighted as significant challenges in managing complex health needs, especially in disadvantaged groups. No study considered identification of signals that a technology may contribute to inequity.

Conclusions: Limited evidence highlighted a lack of consistent approaches to integrating equity into horizon scanning. While methods such as stakeholder engagement and scenario analysis showed promise, further research is needed to refine frameworks that better detect early indicators of inequity in healthcare innovation. This will support research inclusion, reduce research waste, and support development of methods to minimise health inequity in implementation planning.

Declaration of funding: This study/project was funded by the National Institute for Health Research (NIHR) [NIHRIO/project reference HSRIC-2016-10009]. The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.