Abstract:
BACKGROUND:The use of guidelines in general practice is not optimal. Although evidence-based methods to improve guideline adherence are available, variation in physician adherence to general practice guidelines remains relatively high. The objective for this study is to transfer a quality improvement strategy based on audit, feedback, educational materials, and peer group discussion moderated by local opinion leaders to the field. The research questions are: is the multifaceted strategy implemented on a large scale as planned?; what is the effect on general practitioners' (GPs) test ordering and prescribing behaviour?; and what are the costs of implementing the strategy? METHODS:In order to evaluate the effects, costs and feasibility of this new strategy we plan a multi-centre cluster randomized controlled trial (RCT) with a balanced incomplete block design. Local GP groups in the south of the Netherlands already taking part in pharmacotherapeutic audit meeting groups, will be recruited by regional health officers. Approximately 50 groups of GPs will be randomly allocated to two arms. These GPs will be offered two different balanced sets of clinical topics. Each GP within a group will receive comparative feedback on test ordering and prescribing performance. The feedback will be discussed in the group and working agreements will be created after discussion of the guidelines and barriers to change. The data for the feedback will be collected from existing and newly formed databases, both at baseline and after one year. DISCUSSION:We are not aware of published studies on successes and failures of attempts to transfer to the stakeholders in the field a multifaceted strategy aimed at GPs' test ordering and prescribing behaviour. This pragmatic study will focus on compatibility with existing infrastructure, while permitting a certain degree of adaptation to local needs and routines.
journal_name
Implement Scijournal_title
Implementation science : ISauthors
Trietsch J,van der Weijden T,Verstappen W,Janknegt R,Muijrers P,Winkens R,van Steenkiste B,Grol R,Metsemakers Jdoi
10.1186/1748-5908-4-6subject
Has Abstractpub_date
2009-02-17 00:00:00pages
6issn
1748-5908pii
1748-5908-4-6journal_volume
4pub_type
杂志文章abstract:BACKGROUND:Implementation of clinical research results is challenging, yet the responsibility for implementation is seldom addressed. The process from research to the use of clinical research results in health care can be facilitated by research funders. In this paper, we report the roles of ten Swedish research funder...
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journal_title:Implementation science : IS
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journal_title:Implementation science : IS
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journal_title:Implementation science : IS
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journal_title:Implementation science : IS
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journal_title:Implementation science : IS
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journal_title:Implementation science : IS
pub_type: 杂志文章
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journal_title:Implementation science : IS
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更新日期:2013-02-14 00:00:00
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更新日期:2018-05-29 00:00:00
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更新日期:2012-11-26 00:00:00
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更新日期:2011-12-02 00:00:00
abstract:: Delirium occurs in up to 65% of older hip fracture patients. Developing delirium in hospital has been associated with a variety of adverse outcomes. Trials have shown that multi-component preventive interventions can lower delirium rates. The objective of this study was to implement and evaluate the effectiveness of ...
journal_title:Implementation science : IS
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journal_title:Implementation science : IS
pub_type: 杂志文章,评审
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journal_title:Implementation science : IS
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journal_title:Implementation science : IS
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journal_title:Implementation science : IS
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journal_title:Implementation science : IS
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更新日期:2011-02-28 00:00:00
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journal_title:Implementation science : IS
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