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Understanding the uptake of a clinical innovation for osteoarthritis in primary care : a qualitative study of knowledge mobilisation using the i-PARIHS framework

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Swaithes, Laura, Dziedzic, Krysia, Finney, Andrew, Cottrell, Elizabeth, Jinks, Clare, Mallen, Christian, Currie, Graeme and Paskins, Zoe (2020) Understanding the uptake of a clinical innovation for osteoarthritis in primary care : a qualitative study of knowledge mobilisation using the i-PARIHS framework. Implementation Science, 15 (1). 95. doi:10.1186/s13012-020-01055-2

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Official URL: https://doi.org/10.1186/s13012-020-01055-2

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Abstract

Background: 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. Methods: This study used two methods: secondary analysis of focus groups undertaken with general practice staff from 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 (5–8 participants per group), 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 of results. 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. 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 in supporting ongoing implementation by providing facilitation, infrastructure and resource to support the workload burden. ‘Instinctive facilitation’ may involve individuals who do not adopt formal brokering roles or fully recognise their role in mobilising knowledge for implementation. Public contributors and lay communities were not only recipients of healthcare innovations but also potential powerful facilitators of implementation. Conclusion: 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.

Item Type: Journal Article
Subjects: R Medicine > RA Public aspects of medicine
Divisions: Faculty of Social Sciences > Warwick Business School
SWORD Depositor: Library Publications Router
Library of Congress Subject Headings (LCSH): Osteoarthritis , Osteoarthritis -- Diagnosis, Osteoarthritis -- Treatment—Technological innovations, Medical innovations
Journal or Publication Title: Implementation Science
Publisher: BioMed Central
ISSN: 1748-5908
Official Date: 28 October 2020
Dates:
DateEvent
28 October 2020Published
15 October 2020Accepted
Volume: 15
Number: 1
Article Number: 95
DOI: 10.1186/s13012-020-01055-2
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
RP-PG-0407-10386[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
KMRF-2014-03-002[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
NIHR-RP2014-04-026[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
CS-2018-18-ST2-010[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272
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