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A tailored programme to implement recommendations for multimorbid patients with polypharmacy in primary care practices—process evaluation of a cluster randomized trial

Overview of attention for article published in Implementation Science, March 2017
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Title
A tailored programme to implement recommendations for multimorbid patients with polypharmacy in primary care practices—process evaluation of a cluster randomized trial
Published in
Implementation Science, March 2017
DOI 10.1186/s13012-017-0559-y
Pubmed ID
Authors

Cornelia Jäger, Jost Steinhäuser, Tobias Freund, Sarah Kuse, Joachim Szecsenyi, Michel Wensing

Abstract

We developed and evaluated a tailored programme to implement three evidence-based recommendations for multimorbid patients with polypharmacy into primary care practices: structured medication counselling including brown bag reviews, the use of medication lists and medication reviews. No effect on the primary outcome was found. This process evaluation aimed to identify factors associated with outcomes by exploring nine hypotheses specified in the logic model of the tailored programme. The tailored programme was developed with respect to identified determinants of practice and consisted of a workshop for practice teams, elaboration of implementation action plans, aids for medication reviews, a multilingual info-tool for patients on a tablet PC, posters and brown paper bags as reminders for patients. The tailored programme was evaluated in a cluster randomized trial. The process evaluation was based on various data sources: interviews with general practitioners and medical assistants of the intervention group and a survey with general practitioners of the intervention and control group, written reports on the implementation action plans, documentation forms for structured medication counselling and the log file of the info-tool. We analyzed 12 interviews, 21 questionnaires, 120 documentation forms for medication counselling, 5 implementation action plans and one log file of the info-tool. The most frequently reported effect of the tailored programme was the increase of awareness for the health problem and the recommendations, while implementation of routine processes was only reported for structured medication counselling. The survey largely confirmed the usefulness of the applied strategies, yet the interviews provided a more detailed understanding of the actual use of the strategies and several suggestions for modifications of the tailored programme. The tailored programme seemed to have induced awareness as a first step of behaviour change. Several modifications of the tailored programme may enhance its effectiveness such as conducting outreach visits instead of a workshop, improved targeting, provision of evidence, integration of tools into the practice software and information materials in tailored formats. This study is linked to an outcome evaluation study with the registration ISRCTN34664024 , assigned 14/08/2013.

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The data shown below were collected from the profiles of 6 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 98 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 98 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 14 14%
Student > Bachelor 12 12%
Student > Ph. D. Student 11 11%
Student > Postgraduate 7 7%
Student > Master 6 6%
Other 19 19%
Unknown 29 30%
Readers by discipline Count As %
Medicine and Dentistry 27 28%
Nursing and Health Professions 12 12%
Pharmacology, Toxicology and Pharmaceutical Science 6 6%
Psychology 5 5%
Business, Management and Accounting 3 3%
Other 9 9%
Unknown 36 37%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 25 June 2017.
All research outputs
#13,543,199
of 22,958,253 outputs
Outputs from Implementation Science
#1,413
of 1,722 outputs
Outputs of similar age
#162,531
of 311,212 outputs
Outputs of similar age from Implementation Science
#42
of 44 outputs
Altmetric has tracked 22,958,253 research outputs across all sources so far. This one is in the 39th percentile – i.e., 39% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,722 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 14.8. This one is in the 15th percentile – i.e., 15% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 311,212 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 46th percentile – i.e., 46% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 44 others from the same source and published within six weeks on either side of this one. This one is in the 4th percentile – i.e., 4% of its contemporaries scored the same or lower than it.