Tailored implementation of evidence-based practice for patients with chronic diseases
Open accessAbstract
BACKGROUND: When designing interventions and policies to implement evidence based healthcare, tailoring strategies to the targeted individuals and organizations has been recommended. We aimed to gather insights into the ideas of a variety of people for implementing evidence-based practice for patients with chronic diseases, which were generated in five European countries. METHODS: A qualitative study in five countries (Germany, Netherlands, Norway, Poland, United Kingdom) was done, involving overall 115 individuals. A purposeful sample of four categories of stakeholders (healthcare professionals, quality improvement officers, healthcare purchasers and authorities, and health researchers) was involved in group interviews in each of the countries to generate items for improving healthcare in different chronic conditions per country: chronic obstructive pulmonary disease, cardiovascular disease, depression in elderly people, multi-morbidity, obesity. A disease-specific standardized list of determinants of practice in these conditions provided the starting point for these groups. The content of the suggested items was categorized in a pre-defined framework of 7 domains and specific themes in the items were identified within each domain. RESULTS: The 115 individuals involved in the study generated 812 items, of which 586 addressed determinants of practice. These largely mapped onto three domains: individual health professional factors, patient factors, and professional interactions. Few items addressed guideline factors, incentives and resources, capacity of organizational change, or social, political and legal factors. The relative numbers of items in the different domains were largely similar across stakeholder categories within each of the countries. The analysis identified 29 specific themes in the suggested items across countries. CONCLUSION: The type of suggestions for improving healthcare practice was largely similar across different stakeholder groups, mainly addressing healthcare professionals, patient factors and professional interactions. As this study is one of the first of its kind, it is important that more research is done on tailored implementation strategies.
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In the previous review, the rigour of the determinants analyses failed to predict effectiveness.
“However, it was difficult to judge the rigour of the analysis of determinants since little is yet known of the most useful approaches (Huntink 2014; Wensing 2014), and this variable failed to predict effectiveness.”
From Tailored interventions to address determinants of practice (2015) · cites this paper as Wensing 2014
Strategies to address determinants may be selected in different ways.
“Once determinants have been identified and those to be addressed have been chosen, strategies to address them have to be selected, but this process may be undertaken in different ways (Wensing 2014).”
From Tailored interventions to address determinants of practice (2015) · cites this paper as Wensing 2014
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Tailored interventions to address determinants of practice
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“Furthermore, sustainability of implementation over time has been found to be low, which may be due to a failure to match implementation strategies to barriers that are relevant for the continuation of an innovation (Wensing et al. 2014).”
BackgroundHuntink, E., van Lieshout, J., Aakhus, E., Baker, R., Flottorp, S., Godycki-Cwirko, M., Jäger, C., Kowalczyk, A., Szecsenyi, J., & Wensing, M. (2014) · Implementation Science · doi:10.1186/s13012-014-0185-x · Cited by 27 · see citing works
Self-citation
- Authors
- Wensing, M., Huntink, E., van Lieshout, J., Godycki-Cwirko, M., Kowalczyk, A., Jäger, C., Steinhäuser, J., Aakhus, E., Flottorp, S., Eccles, M., & Baker, R.
- Affiliations
- Radboud University Medical Center (NL)
- Medical University of Lodz (PL)
- University Hospital Heidelberg (DE)
- Nasjonalt Kunnskapssenter for Helsetjenesten (NO)
- Newcastle University (GB)
- University of Leicester (GB)
- Corresponding author
- Wensing, Michel
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2014-07-08
- Volume
- 9
- Issue
- 7
- Pages
- e101981
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4087017
- OpenAlex
- W2119270647
- Cited by
- 74
- References
- 25
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 3 · 2023: 9 · 2022: 5 · 2021: 11 · 2020: 6 · 2019: 5 · 2018: 3 · 2017: 8 · 2016: 5 · 2015: 12 · 2014: 1
- FWCI
- 15.69
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Figshare (submittedVersion, cc-by)
- Leicester Research Archive (University of Leicester) (submittedVersion, cc-by)
- Radboud Repository (Radboud University) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- Funders
- European Commission (258837, 2007–2013, FP7 2007-2013, FP7/2007)
- ZonMw (200310011)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
- Keywords
- evidence-based practice implementation, chronic disease, stakeholder perspectives, healthcare workers, patient factors, professional interaction, chronic obstructive pulmonary disease, cardiovascular disease, geriatric depression, multimorbidity, obesity, cross-national comparison
- MeSH terms
- Chronic Disease, Humans, Practice Guidelines as Topic, Evidence-Based Medicine, Disease Management, Precision Medicine
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