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Osteoarthritis is a leading cause of pain and disability worldwide. Despite research supporting best practice, evidence-based guidelines are often not followed. Little is known about the implementation of non-surgical models of care in routine primary care practice. From a knowledge mobilisation perspective, the aim of this study was to understand the uptake of a clinical innovation for osteoarthritis and explore the journey from a clinical trial to implementation.
This study used two methods: secondary analysis of focus groups undertaken with general practice staff https://amazonia.fiocruz.br/scdp/blog/purpose-of-case-study-in-psychology/the-greenhouse-movement-helps.php the Managing OSteoArthritis in ConsultationS research trial, which investigated the effectiveness of an enhanced osteoarthritis consultation, and interviews with stakeholders from an implementation project which started post-trial following demand from general practices.
Data from three focus groups with 21 multi-disciplinary clinical professionals The present study used qualitative research methods participants per group shudy, and 13 interviews with clinical and non-clinical stakeholders, were thematically analysed utilising the Integrated Promoting Action on Research Implementation in Health Services i-PARIHS framework, in a theoretically informative approach. Public contributors were involved in topic guide design and interpretation kethods results. In operationalising implementation of an innovation for osteoarthritis following a trial, the importance of a whole practice approach, including the opportunity for reflection and planning, were identified.
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The end of a clinical trial provided opportune timing for facilitating implementation planning. In the context of osteoarthritis in primary care, facilitation by an inter-disciplinary knowledge brokering service, nested within an academic institution, was instrumental Tye supporting ongoing implementation by providing facilitation, infrastructure and resource to support the workload burden. Public contributors and lay communities were not only recipients of healthcare innovations but also potential powerful facilitators of implementation. This theoretically informed knowledge mobilisation study into the uptake of a clinical innovation for osteoarthritis in primary care has enabled further characterisation of the facilitation and recipient constructs of i-PARIHS by describing optimum timing for facilitation and roles and characteristics of facilitators.
Peer Review reports. Osteoarthritis OA is the most common joint disorder in the Western world. It is a leading cause of pain, loss of function and disability worldwide and is predominantly managed in primary care [ 1 ]. Despite international evidence-based guidelines that support best practice, management mtehods OA remains suboptimal [ 23 ]. Core approaches for managing OA, such as exercise, are underutilised and the quality of care for adults with OA is inconsistent [ 4 ].
Internationally, effective non-surgical models of OA care do not inevitably translate to improved clinical practice that benefits https://amazonia.fiocruz.br/scdp/blog/culture-and-selfaeesteem/the-exploration-of-open-spaces.php [ 567 ].
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Where post-trial implementation does occur, little is known about how this is achieved in different contexts [ 8 ]. Factors that influence implementation of models of care, across a range of conditions in primary care, have been identified [ 910 ].
Public awareness, resources, philosophy of care and ease of implementation are possible barriers and facilitators of implementation [ 9 ]. Strategies such as educational meetings, visits and audit have the potential to optimise the process [ resewrch ]. Implementation of empirically tested approaches can be challenging if wider influences are not accounted for.
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Failed implementation efforts pose health, economic and opportunity costs [ 12 ]. Knowledge mobilisation KM is a perspective that recognises the non-linearity associated with the dynamic nature of creating, sharing and using knowledge across practice domains qualittive improve outcomes and efficiency for relevant stakeholders [ 1314 ].
The complexity of KM is compounded by the interaction of multiple systems, policy, organisational and personal factors [ 15 ]. A recent systematic review click to see more the factors that influence implementation of evidence-based guidelines for OA in primary care identified a paucity of studies and illustrated the challenges in identifying and mobilising knowledge relevant to policy, practices and individuals to optimise implementation [ 8 ]. This study aimed to understand the uptake of a clinical innovation for OA and explore the transition of knowledge from a clinical trial to implementation from a KM perspective, using the Integrated Promoting Action on Research Implementation in Health Services i-PARIHS framework in a theoretically informative approach.
A model OA consultation for primary care to deliver NICE recommendations comprising a general practitioner GP consultation to make, give and explain the diagnosis of OA and up to four consultations with a practice nurse PN The present study used qualitative research methods support self-management [ 18 ]. An OA guidebook providing high-quality written information designed by patients [ 23 ]. GP and nurse training to deliver the model consultation [ 2425 ].
OA e-template to record OA-associated codes in electronic health records [ 26 ]. To recognise and reward their participation in the study, the four control practices in the MOSAICS trial received whole-practice training on the key components of the enhanced OA consultation, at trial end, prior to the results being known. The training was a condensed version of that given to the intervention practices but incorporated practice-based learning that had arisen during the trial [ 2728 ].]
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