“You've just got to have it ready for when they're ready” – Australian policymakers’ perceptions of living evidence synthesis and its opportunity to support health policy

Background: Effective health policy is informed by research evidence; however, there are challenges to using up-to-date research evidence to inform policy decisions. The living evidence synthesis (LES) approach aims to overcome some of these challenges by providing decision-makers with summaries of the research evidence on topics of interest, updated as new evidence becomes available. As yet, little is known about when, why and how policymakers use LES, and the implications of this use. The aim of this study was to describe policymakers’ perceptions of LES and characterise opportunities for, and challenges to using LES to inform health policy in Australia. Methods: Health policymakers at Australian federal and state or territory health departments participated in semi-structured online interviews exploring their motivations and experiences for using LES and factors that may influence their future use. Preliminary themes were clarified and interpreted at an online roundtable. A purposive sample was used to obtain views across diverse policy settings and geographical locations. The interviews and roundtable findings were triangulated using an applied thematic analysis approach. Results: Twenty-two policymakers participated and provided insights on five broad themes relevant to health policy: varied understanding but consistent expectations of LES; criteria for when to use LES; key merits of using LES; perceived risks associated with LES; and considerations for future use of LES. The use of LES was motivated by the need for current research to inform imminent policy decisions. It was most useful in the context of an evolving issue which requires a government response, where research evidence on the issue is emerging, and when living evidence syntheses are accessible, trustworthy and available. The key merits of using LES were the currency and trustworthiness of this approach, and a key risk was damage to credibility from potentially changing evidence. Policymakers were enthusiastic about the future use of LES and discussed health system factors, resources, communication, collaboration and technological factors that could enhance the optimal use of LES in policy. Conclusion: This study demonstrated that most policymakers who had used LES valued them. It highlighted opportunities for improvement to enable ongoing LES to inform health policy. By working in partnership, policymakers, knowledge users, and evidence producers can further understand and optimise this approach to realise the potential to strengthen health systems by enabling the use of up-to-date evidence in policy decisions.