Objective: To compare the proportions of effective primary prevention interventions for non-communicable diseases with the proportions of effective prevention interventions delivered in practice.
Methods: An overview of systematic reviews on prevention interventions tackling tobacco smoking, obesity, and cardiovascular disease, was carried out. Individual trials were extracted, and their results were organised by intervention effectiveness. Medline was searched to describe the effectiveness of the interventions implemented in practice.
Results: We found 11 systematic reviews, 4 focusing on prevention of cardiovascular diseases (including 150 trials), 1 on obesity (55), and 6 on tobacco smoking (219). Out of all interventions, 34.9% revealed some evidence of effectiveness, whereas 3.6% provided evidence of adverse effects. We identified 4 studies reporting proportions of effective prevention interventions ranging from 20%to 35%in the United States. A 2008 survey reported 1,501 behavioural prevention interventions implemented in Italy, 1% of which was evidence-based.
Discussion: Only 35% of prevention interventions provided some evidence of effectiveness. Some interventions had harmful effects. Most of implemented interventions have never been evaluated. Actions are urgently needed to ensure that delivered interventions are effective and safe, for example by developing an approval system of prevention interventions.