SynthesisBMJ open2026
From legalisation to practice: implementation of newly legalised health interventions in healthcare settings - a systematic review.
Synthesis in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesOver the last decade, a growing number of health interventions (eg, medical assistance in dying and mitochondrial donation) have become legalised or decriminalised globally. Newly legalised health interventions share characteristics that are distinct from other health interventions, making their implementation more challenging. They are often highly emotive, controversial and associated with strong opinions and ethical dilemmas, with some of them being high-stake and irreversible. This study aimed to identify, systematise and map the factors that affect the implementation of health interventions that have recently been legalised.
designA systematically conducted review. DATA SOURCES: PubMed, Scopus, EMBASE and CINAHL were searched to identify studies published between 2014 and 2024. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: We included studies if they evaluated the implementation of health interventions that were newly legalised or newly decriminalised. DATA EXTRACTION AND SYNTHESIS: Data were extracted and synthesised through descriptive analysis. Both deductive and inductive thematic analyses were applied to map the barriers, facilitators and implementing strategies that influence the implementation of newly legalised health interventions in healthcare settings.
resultsThe search strategy yielded 1510 publications, of which 78 were included in this review. Findings showed that several newly legalised health interventions, including medical assistance in dying (n=56 studies); medical abortion (n=13); assisted human reproduction (n=3); psychedelic-assisted therapies (n=3); use of medical cannabis (n=2) and use of biosimilars (n=1) were addressed. The analysis identified a total of 880 diverse barriers, facilitators and strategies in five domains across system, organisational and individual levels: (1) patients/service users/consumers; (2) healthcare providers; (3) healthcare organisation; (4) legal processes and (5) system. These were further divided into 27 themes of barriers, 18 themes of facilitators and 17 themes of strategies.
conclusionsImplementing newly legalised health interventions is complex. Our findings can support the development of an implementation plan for the spread and scaling of future health interventions, maximising the impact of interventions and making them accessible to more people and health organisations.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.