Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/25240
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dc.contributor.authorGrant, Aileenen_UK
dc.contributor.authorDreischulte, Tobiasen_UK
dc.contributor.authorGuthrie, Bruceen_UK
dc.date.accessioned2017-05-16T23:12:12Z-
dc.date.available2017-05-16T23:12:12Z-
dc.date.issued2017-03-31en_UK
dc.identifier.othere015281en_UK
dc.identifier.urihttp://hdl.handle.net/1893/25240-
dc.description.abstractObjective To explore how different practices responded to the Data-driven Quality Improvement in Primary Care (DQIP) intervention in terms of their adoption of the work, reorganisation to deliver the intended change in care to patients, and whether implementation was sustained over time.  Design Mixed-methods parallel process evaluation of a cluster trial, reporting the comparative case study of purposively selected practices.  Setting Ten (30%) primary care practices participating in the trial from Scotland, UK.  Results Four practices were sampled because they had large rapid reductions in targeted prescribing. They all had internal agreement that the topic mattered, made early plans to implement including assigning responsibility for work and regularly evaluated progress. However, how they internally organised the work varied. Six practices were sampled because they had initial implementation failure. Implementation failure occurred at different stages depending on practice context, including internal disagreement about whether the work was worthwhile, and intention but lack of capacity to implement or sustain implementation due to unfilled posts or sickness. Practice context was not fixed, and most practices with initial failed implementation adapted to deliver at least some elements. All interviewed participants valued the intervention because it was an innovative way to address on an important aspect of safety (although one of the non-interviewed general practitioners in one practice disagreed with this). Participants felt that reviewing existing prescribing did influence their future initiation of targeted drugs, but raised concerns about sustainability.  Conclusions Variation in implementation and effectiveness was associated with differences in how practices valued, engaged with and sustained the work required. Initial implementation failure varied with practice context, but was not static, with most practices at least partially implementing by the end of the trial. Practices organised their delivery of changed care to patients in ways which suited their context, emphasising the importance of flexibility in any future widespread implementation.en_UK
dc.language.isoenen_UK
dc.publisherBMJ Publishing Groupen_UK
dc.relationGrant A, Dreischulte T & Guthrie B (2017) Process evaluation of the Data-driven Quality Improvement in Primary Care (DQIP) trial: Case study evaluation of adoption and maintenance of a complex intervention to reduce high-risk primary care prescribing. BMJ Open, 7 (3), Art. No.: e015281. https://doi.org/10.1136/bmjopen-2016-015281en_UK
dc.rightsPublished by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/en_UK
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/en_UK
dc.titleProcess evaluation of the Data-driven Quality Improvement in Primary Care (DQIP) trial: Case study evaluation of adoption and maintenance of a complex intervention to reduce high-risk primary care prescribingen_UK
dc.typeJournal Articleen_UK
dc.identifier.doi10.1136/bmjopen-2016-015281en_UK
dc.identifier.pmid28283493en_UK
dc.citation.jtitleBMJ Openen_UK
dc.citation.issn2044-6055en_UK
dc.citation.volume7en_UK
dc.citation.issue3en_UK
dc.citation.publicationstatusPublisheden_UK
dc.citation.peerreviewedRefereeden_UK
dc.type.statusVoR - Version of Recorden_UK
dc.citation.date10/03/2017en_UK
dc.contributor.affiliationHealth Sciences Stirlingen_UK
dc.contributor.affiliationNHS Taysideen_UK
dc.contributor.affiliationUniversity of Dundeeen_UK
dc.identifier.isiWOS:000398959400196en_UK
dc.identifier.scopusid2-s2.0-85015241228en_UK
dc.identifier.wtid532207en_UK
dc.contributor.orcid0000-0001-6146-101Xen_UK
dc.date.accepted2017-02-14en_UK
dcterms.dateAccepted2017-02-14en_UK
dc.date.filedepositdate2017-03-31en_UK
rioxxterms.apcnot requireden_UK
rioxxterms.typeJournal Article/Reviewen_UK
rioxxterms.versionVoRen_UK
local.rioxx.authorGrant, Aileen|0000-0001-6146-101Xen_UK
local.rioxx.authorDreischulte, Tobias|en_UK
local.rioxx.authorGuthrie, Bruce|en_UK
local.rioxx.projectInternal Project|University of Stirling|https://isni.org/isni/0000000122484331en_UK
local.rioxx.freetoreaddate2017-03-31en_UK
local.rioxx.licencehttp://creativecommons.org/licenses/by-nc/4.0/|2017-03-31|en_UK
local.rioxx.filenamee015281.full.pdfen_UK
local.rioxx.filecount1en_UK
local.rioxx.source2044-6055en_UK
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