Abstract:
BACKGROUND:The Portuguese National Health Directorate has issued clinical practice guidelines on prescription of anti-inflammatory drugs, acid suppressive therapy, and antiplatelets. However, their effectiveness in changing actual practice is unknown. METHODS:The study will compare the effectiveness of educational outreach visits regarding the improvement of compliance with clinical guidelines in primary care against usual dissemination strategies. A cost-benefit analysis will also be conducted. We will carry out a parallel, open, superiority, randomized trial directed to primary care physicians. Physicians will be recruited and allocated at a cluster-level (primary care unit) by minimization. Data will be analyzed at the physician level. Primary care units will be eligible if they use electronic prescribing and have at least four physicians willing to participate. Physicians in intervention units will be offered individual educational outreach visits (one for each guideline) at their workplace during a six-month period. Physicians in the control group will be offered a single unrelated group training session. Primary outcomes will be the proportion of cyclooxygenase-2 inhibitors prescribed in the anti-inflammatory class, and the proportion of omeprazole in the proton pump inhibitors class at 18 months post-intervention. Prescription data will be collected from the regional pharmacy claims database. We estimated a sample size of 110 physicians in each group, corresponding to 19 clusters with a mean size of 6 physicians. Outcome collection and data analysis will be blinded to allocation, but due to the nature of the intervention, physicians and detailers cannot be blinded. DISCUSSION:This trial will attempt to address unresolved issues in the literature, namely, long term persistence of effect, the importance of sequential visits in an outreach program, and cost issues. If successful, this trial may be the cornerstone for deploying large scale educational outreach programs within the Portuguese National Health Service. TRIAL REGISTRATION:ClinicalTrials.gov number NCT01984034.
journal_name
Implement Scijournal_title
Implementation science : ISauthors
Pinto D,Heleno B,Rodrigues DS,Papoila AL,Santos I,Caetano PAdoi
10.1186/1748-5908-9-10subject
Has Abstractpub_date
2014-01-15 00:00:00pages
10issn
1748-5908pii
1748-5908-9-10journal_volume
9pub_type
杂志文章,随机对照试验abstract:BACKGROUND:The fields of implementation and improvement sciences have experienced rapid growth in recent years. However, research that seeks to inform health care change may have difficulty translating core components of implementation and improvement sciences within the traditional paradigms used to evaluate efficacy ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-018-0770-5
更新日期:2018-05-29 00:00:00
abstract:BACKGROUND:Denmark has inferior cancer survival rates compared with many European countries. The main reason for this is suggested to be late diagnosis at advanced cancer stages. Cancer diagnostic work-up begins in general practice in 85% of all cancer cases. Thus, general practitioners (GPs) play a key role in the dia...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/s13012-014-0159-z
更新日期:2014-11-07 00:00:00
abstract::Implementing research findings into healthcare practice and policy is a complex process occurring in diverse contexts; it invariably depends on changing human behaviour in many parts of an intricate implementation system. Questions asked with the aim of improving implementation are multifarious variants of 'What works...
journal_title:Implementation science : IS
pub_type: 社论
doi:10.1186/s13012-017-0660-2
更新日期:2017-11-14 00:00:00
abstract:BACKGROUND:Over the past years, implementation science has gained more and more importance in German-speaking countries. Reliable and valid questionnaires are needed for evaluating the implementation of evidence-based practices. On an international level, several initiatives focused on the identification of questionnai...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-018-0837-3
更新日期:2018-12-12 00:00:00
abstract:BACKGROUND:Over the past decade, prevalence of maternal and child morbidity and mortality in Togo, particularly in the northern regions, has remained high despite global progress. The causes of under-five child mortality in Togo are diseases with effective and low-cost prevention and/or treatment strategies, including ...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/s13012-019-0921-3
更新日期:2019-10-16 00:00:00
abstract:BACKGROUND:While it is recommended that childcare services implement policies and practices to support obesity prevention, there remains limited evidence to inform policy and practice. The aim of this study is to examine the effectiveness of performance review and facilitated feedback in increasing the implementation o...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/s13012-019-0865-7
更新日期:2019-02-18 00:00:00
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 ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-4-6
更新日期:2009-02-17 00:00:00
abstract:BACKGROUND:For early stage breast cancer, randomized controlled trials (RCTs) have shown that patient decision aids (PtDAs), when used by surgeons, result in increased patient knowledge about options and different patient treatment choices as compared to standard care. Yet, recent data suggests that PtDAs are used by l...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-014-0174-0
更新日期:2014-11-29 00:00:00
abstract:BACKGROUND:Scientific knowledge is in constant change. The flow of new information requires a frequent re-evaluation of the available research results. Clinical practice guidelines (CPGs) are not exempted from this phenomenon and need to be kept updated to maintain the validity of their recommendations. The objective o...
journal_title:Implementation science : IS
pub_type: 杂志文章,评审
doi:10.1186/1748-5908-7-109
更新日期:2012-11-19 00:00:00
abstract:BACKGROUND:In 2004, Gabbay and le May showed that clinicians generally base their decisions on mindlines-internalised and collectively reinforced tacit guidelines-rather than consulting written clinical guidelines. We considered how the concept of mindlines has been taken forward since. METHODS:We searched databases f...
journal_title:Implementation science : IS
pub_type: 杂志文章,评审
doi:10.1186/s13012-015-0229-x
更新日期:2015-04-09 00:00:00
abstract:BACKGROUND:Planning a public health initiative is both a science and an art. Public health practitioners work in a complex, often time-constrained environment, where formal research literature can be unavailable or uncertain. Consequently, public health practitioners often draw upon other forms of knowledge. METHODS:T...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-7-20
更新日期:2012-03-20 00:00:00
abstract:BACKGROUND:Use of direct oral anticoagulants (DOAC) is rapidly growing for treatment of atrial fibrillation and venous thromboembolism. However, incorrect dosing of these medications is common and puts patients at risk of adverse drug events. One way to improve safe prescribing is the use of population health tools, in...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-020-01044-5
更新日期:2020-09-21 00:00:00
abstract:BACKGROUND:The Centers for Disease Control (2018) estimates that 1 in 59 children has autism spectrum disorder, and the annual cost of ASD in the U.S. is estimated to be $236 billion. Evidence-based interventions have been developed and demonstrate effectiveness in improving child outcomes. However, research on general...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-018-0757-2
更新日期:2018-05-09 00:00:00
abstract:BACKGROUND:Continued improvements in occupational health can only be ensured if decisions regarding the implementation and continuation of occupational health and safety interventions (OHS interventions) are based on the best available evidence. To ensure that this is the case, scientific evidence should meet the needs...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-8-57
更新日期:2013-06-03 00:00:00
abstract:BACKGROUND:How humans think and make decisions is important in understanding behaviour. Hence an understanding of cognitive processes among physicians may inform our understanding of behaviour in relation to evidence implementation strategies. A personality theory, Cognitive-Experiential Self Theory (CEST) proposes a r...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-3-23
更新日期:2008-04-25 00:00:00
abstract:BACKGROUND:Hand hygiene prescriptions are the most important measure in the prevention of hospital-acquired infections. Yet, compliance rates are generally below 50% of all opportunities for hand hygiene. This study aims at evaluating the short- and long-term effects of two different strategies for promoting hand hygie...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/1748-5908-6-101
更新日期:2011-09-03 00:00:00
abstract:BACKGROUND:Patients with hypertension continue to have less than optimal blood pressure control, with nearly one in five Canadian adults having hypertension. Pharmacist prescribing is gaining favor as a potential clinically efficacious and cost-effective means to improve both access and quality of care. With Alberta be...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/1748-5908-6-94
更新日期:2011-08-11 00:00:00
abstract:BACKGROUND:Integrated knowledge translation (IKT) refers to collaboration between researchers and decision-makers. While advocated as an approach for enhancing the relevance and use of research, IKT is challenging and inconsistently applied. This study sought to inform future IKT practice and research by synthesizing s...
journal_title:Implementation science : IS
pub_type: 杂志文章,评审
doi:10.1186/s13012-016-0399-1
更新日期:2016-03-17 00:00:00
abstract:BACKGROUND:The Implementation Research Institute (IRI) provides two years of training in mental health implementation science for 10 new fellows each year. The IRI is supported by a National Institute of Mental Health (NIMH) R25 grant and the Department of Veterans Affairs (VA). Fellows attend two annual week-long trai...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-8-105
更新日期:2013-09-05 00:00:00
abstract:BACKGROUND:Previous efforts to produce case descriptions have typically not focused on the organizations that produce research evidence and support its use. External evaluations of such organizations have typically not been analyzed as a group to identify the lessons that have emerged across multiple evaluations. Case ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-3-56
更新日期:2008-12-17 00:00:00
abstract:BACKGROUND:Shared decision-making (SDM) is rarely implemented in pediatric practice. Pediatric health decision-making differs from that of adult practice. Yet, little is known about the factors that influence the implementation of pediatric shared decision-making (SDM). We synthesized pediatric SDM barriers and facilit...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-018-0851-5
更新日期:2019-01-18 00:00:00
abstract:BACKGROUND:To better understand the efficacy of various implementation strategies, improved methods for describing and classifying the nature of these strategies are urgently required. The aim of this study was to develop and pilot the feasibility of a taxonomy to classify the nature and content of implementation strat...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-8-32
更新日期:2013-03-15 00:00:00
abstract:BACKGROUND:Children with emotional and behavioural disorders should be able to count on receiving care that meets their needs and is based on the best scientific evidence available, however, many do not receive these services. Implementation of evidence-based practice (EBP) relies, in part, on the research utilization ...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/1748-5908-3-19
更新日期:2008-04-09 00:00:00
abstract:BACKGROUND:Services to treat tobacco dependence are not readily available to smokers in low-middle income countries (LMICs) where smoking prevalence remains high. We are conducting a cluster randomized controlled trial comparing the effectiveness of two strategies for implementing tobacco use treatment guidelines in 26...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-017-0558-z
更新日期:2017-02-28 00:00:00
abstract:BACKGROUND:Pay-for-performance (P4P) has been recommended as a promising strategy to improve implementation of high-quality care. This study examined the incremental cost-effectiveness of a P4P strategy found to be highly effective in improving the implementation and effectiveness of the Adolescent Community Reinforcem...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/s13012-018-0774-1
更新日期:2018-07-04 00:00:00
abstract:BACKGROUND:The Department of Veterans Affairs (VA) has led the industry in measuring facility performance as a critical element in improving quality of care, investing substantial resources to develop and maintain valid and cost-effective measures. The External Peer Review Program (EPRP) of the VA is the official data ...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究
doi:10.1186/1748-5908-7-45
更新日期:2012-05-18 00:00:00
abstract:BACKGROUND:Implementation of the 'Sepsis Six' clinical care bundle within an hour of recognition of sepsis is recommended as an approach to reduce mortality in patients with sepsis, but achieving reliable delivery of the bundle has proved challenging. There remains little understanding of the barriers to reliable imple...
journal_title:Implementation science : IS
pub_type: 杂志文章,多中心研究
doi:10.1186/s13012-016-0518-z
更新日期:2016-11-16 00:00:00
abstract:BACKGROUND:For the optimal use of clinical guidelines in daily practice, mere distribution of guidelines and materials is not enough, and active implementation is needed. This review investigated the effectiveness of multifaceted implementation strategies compared to minimal, single, or no implementation strategy for t...
journal_title:Implementation science : IS
pub_type: 杂志文章,评审
doi:10.1186/s13012-016-0482-7
更新日期:2016-09-20 00:00:00
abstract:BACKGROUND:Effective web-assisted tobacco interventions (WATIs) have been underutilized by smokers; moreover, despite practice guideline recommendations, clinical teams do not routinely refer smokers to WATIs. Our goal was to test a clinical practice innovation, an ePortal designed to change practice and patient behavi...
journal_title:Implementation science : IS
pub_type: 杂志文章,随机对照试验
doi:10.1186/s13012-015-0336-8
更新日期:2015-11-02 00:00:00
abstract:BACKGROUND:Health practice guidelines (HPGs) are important tools for the translation of evidence into practice. Reporting Items for Practice Guidelines in HealThcare (RIGHT) checklist provides guidance on reporting health practice guidelines (HPGs). We assessed the reporting completeness and quality of a set of nationa...
journal_title:Implementation science : IS
pub_type: 杂志文章
doi:10.1186/s13012-018-0828-4
更新日期:2018-10-29 00:00:00