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dc.contributor.authorKrause, Janeen_US
dc.contributor.authorVan Lieshout, Janen_US
dc.contributor.authorKlomp, Rienen_US
dc.contributor.authorHuntink, Elkeen_US
dc.contributor.authorAakhus, Eivinden_US
dc.contributor.authorFlottorp, Signeen_US
dc.contributor.authorJaeger, Corneliaen_US
dc.contributor.authorSteinhaeuser, Josten_US
dc.contributor.authorGodycki-Cwirko, Macieken_US
dc.contributor.authorKowalczyk, Annaen_US
dc.contributor.authorAgarwal, Shonaen_US
dc.contributor.authorWensing, Michelen_US
dc.contributor.authorBaker, Richarden_US
dc.description.abstractBackground: The tailoring of implementation interventions includes the identification of the determinants of, or barriers to, healthcare practice. Different methods for identifying determinants have been used in implementation projects, but which methods are most appropriate to use is unknown. Methods: The study was undertaken in five European countries, recommendations for a different chronic condition being addressed in each country: Germany (polypharmacy in multimorbid patients); the Netherlands (cardiovascular risk management); Norway (depression in the elderly); Poland (chronic obstructive pulmonary disease—COPD); and the United Kingdom (UK) (obesity). Using samples of professionals and patients in each country, three methods were compared directly: brainstorming amongst health professionals, interviews of health professionals, and interviews of patients. The additional value of discussion structured through reference to a checklist of determinants in addition to brainstorming, and determinants identified by open questions in a questionnaire survey, were investigated separately. The questionnaire, which included closed questions derived from a checklist of determinants, was administered to samples of health professionals in each country. Determinants were classified according to whether it was likely that they would inform the design of an implementation intervention (defined as plausibly important determinants). Results: A total of 601 determinants judged to be plausibly important were identified. An additional 609 determinants were judged to be unlikely to inform an implementation intervention, and were classified as not plausibly important. Brainstorming identified 194 of the plausibly important determinants, health professional interviews 152, patient interviews 63, and open questions 48. Structured group discussion identified 144 plausibly important determinants in addition to those already identified by brainstorming. Conclusions: Systematic methods can lead to the identification of large numbers of determinants. Tailoring will usually include a process to decide, from all the determinants that are identified, those to be addressed by implementation interventions. There is no best buy of methods to identify determinants, and a combination should be used, depending on the topic and setting. Brainstorming is a simple, low cost method that could be relevant to many tailored implementation projects.en_US
dc.publisherBioMed Centraleng
dc.rightsAttribution CC BYeng
dc.subjectChronic diseaseeng
dc.subjectGuideline adherenceeng
dc.subjectQuality assuranceeng
dc.titleIdentifying determinants of care for tailoring implementation in chronic diseases: an evaluation of different methodsen_US
dc.typePeer reviewed
dc.typeJournal article
dc.rights.holderCopyright 2014 Krause et al.; licensee BioMed Central Ltd.
dc.rights.holderJane Krause et al.; licensee BioMed Central Ltd.
dc.source.journalImplementation Science

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