A benchmark for the quality of reflexology intervention reporting using the Template for Intervention Description and Replication (TIDieR) checklist: a systematic review

Introduction - Reflexology is a complementary therapy based on the theory that different points on the feet, hands, face, and ears correspond with areas of the body, each being represented as a reflex. Different reflexology practises exist, and there is not one ‘standard’ approach. Not all reflexology studies are documented to a sufficiently high standard to allow research studies to be replicated and their data combined within meta-analysis, which would support a move to evidence-based practice for this complementary therapy. To identify specific shortfalls within reflexology intervention reporting, and to provide a benchmark which could be used to measure any future changes in the detail included in reflexology intervention reporting, the Template for Intervention Description and Replication (TIDieR) checklist has been used to assess the current situation.

Methods - A systematic review was carried out on studies published in 2021 and each study scored using the 12 TIDieR elements for compliance.

Results - 420 references were identified resulting in 41 eligible studies. Among the 12 TIDieR elements assessed, four elements (2: Why, 6: How, 7: Where, and 8: When and how much) were consistently addressed satisfactorily by the majority of the studies. Two elements (9: Tailoring and 12: How well actual) exhibited moderate levels of compliance, four TIDieR elements (1: Brief name, 3: What materials, 4: What procedures, and 5: Who) were predominantly addressed inadequately across the studies and two elements (10: Modifications and 11: How well planned) were rarely included in the studies analyzed.

Conclusion - Many studies did not adequately report the reflexology intervention, which inhibits implementation (and discontinuation), replication, and research synthesis. This systematic review has identified the specific areas of the intervention which are not being documented with sufficient detail in order to highlight areas requiring improvement and produce a benchmark against which the quality of the intervention reporting can be measured in future studies. Data collected as part of this review have been used as input into a follow-up study which has produced reflexology specific guidance to be used with the TIDieR checklist.