Description : For the last ten years, “vulnerability” and “vulnerable populations” have been used
in medical literature. SPICES (Scaling up Packages of Interventions for Cardiovascular
disease prevention in selected sites in Europe and Sub-saharian africa) is an implementation
study which will implement effective primary cardiovascular prevention interventions.
It targets populations who are usually excluded from prevention. Those populations
could fall within the definition of vulnerable populations. Research question : what
is the definition of vulnerability in the medical literature? Methods : a systematic
review was conducted on Cochrane, Medline, Pubmed and Google Scholar databases using
the PRISMA methodology. Meta-analyzes, systematic reviews and randomized controlled
trials were included if they followed the IMRAD format, were in English or French,
addressed vulnerability or vulnerable populations and were published to January 2018.
Definitions were compared and classified using the MesH terminology and a similarity
software. A frequency of vulnerability factors among the definitions was calculated.
Results : of the 588 eligible articles, 15 articles were initially included. Their
bibliography was screened adding 13 articles. There was no consensual definition of
vulnerability. The most frequent vulnerability factors were elderly (68%), race and
ethnic minorities (64%), chronic conditions (64%), low income (57%), limited access
to care and services (50%). Three studies used the EquiFrame framework, which promoted
inclusion of vulnerable groups for health policies. Aday’s definition referred to
vulnerable subpopulations. Discussion : the term of vulnerable populations” did not
fit to the SPICES project. Aday’s definition seemed the most appropriate for medical
research. A consensual definition of vulnerability would be needed.;
Pays