Improving the implementation of tailored expectant management in subfertile couples: protocol for a cluster randomized trial
Autor: | Noortje M, van den Boogaard, Fleur A M, Kersten, Mariëtte, Goddijn, Patrick M M, Bossuyt, Fulco, van der Veen, Peter G A, Hompes, Rosella P M G, Hermens, Didi D M, Braat, Ben Willem J, Mol, Willianne L D M, Nelen, Jacobien, van der Ploeg |
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Přispěvatelé: | Obstetrics and gynaecology, ICaR - Ischemia and repair, Reproductive Origins of Adult Health and Disease (ROAHD), Other departments, Amsterdam Reproduction & Development (AR&D), Center for Reproductive Medicine, Amsterdam Public Health, Epidemiology and Data Science, 10 Public Health & Methodologie, Obstetrics and Gynaecology |
Jazyk: | angličtina |
Předmět: |
Male
Package insert Cost-Benefit Analysis Health Informatics Fertilization in Vitro Health informatics Health administration Feedback Study Protocol Nursing Clinical Protocols Patient Education as Topic Medicine Cluster Analysis Humans Cluster randomised controlled trial Watchful Waiting Health policy Infertility Male Netherlands Protocol (science) Medicine(all) Medical Audit business.industry Health Policy Health services research Public Health Environmental and Occupational Health General Medicine Guideline Outcome and Process Assessment (Health Care) Outcome and Process Assessment Health Care Treatment Outcome Infertility Practice Guidelines as Topic Female Pamphlets Guideline Adherence business Delivery of Health Care Infertility Female |
Zdroj: | Implementation Science, 8:53. BioMed Central Implementation Science, 8:53. BMC van den Boogaard, N M, Kersten, F A M, Goddijn, M, Bossuyt, P M M, van der Veen, F, Hompes, P G A, Hermens, R P M G, Braat, D D M, Mol, B J & Nelen, W L D M 2013, ' Improving the implementation of tailored expectant management in subfertile couples: protocol for a cluster randomized trial ', Implementation Science, vol. 8, 53 . https://doi.org/10.1186/1748-5908-8-53 Implementation Science : IS IMPLEMENTATION SCIENCE, 8(1). BioMed Central |
ISSN: | 1748-5908 |
DOI: | 10.1186/1748-5908-8-53 |
Popis: | BACKGROUND: Prognostic models in reproductive medicine can help to identify subfertile couples who would benefit from fertility treatment. Expectant management in couples with a good chance of natural conception, i.e., tailored expectant management (TEM), prevents unnecessary treatment and is therefore recommended in international fertility guidelines. However, current implementation is not optimal, leaving room for improvement. Based on barriers and facilitators for TEM that were recently identified among professionals and subfertile couples, we have developed a multifaceted implementation strategy. The goal of this study is to assess the effects of this implementation strategy on the guideline adherence on TEM.METHODS/DESIGN: In a cluster randomized trial, 25 clinics and their allied practitioners units will be randomized between the multifaceted implementation strategy and care as usual. Randomization will be stratified for in vitro fertilization (IVF) facilities (full licensed, intermediate/no IVF facilities). The effect of the implementation strategy, i.e., the percentage guideline adherence on TEM, will be evaluated by pre- and post-randomization data collection. Furthermore, there will be a process and cost evaluation of the strategy. The implementation strategy will focus on subfertile couples and their care providers i.e., general practitioners (GPs), fertility doctors, and gynecologists. The implementation strategy addresses three levels: patient level: education materials in the form of a patient information leaflet and a website; professional level: audit and feedback, educational outreach visit, communication training, and access to a digital version of the prognostic model of Hunault on a website; organizational level: providing a protocol based on the guideline. The primary outcome will be the percentage guideline adherence on TEM. Additional outcome measures will be treatment-, patient-, and process-related outcome measures.DISCUSSION: This study will provide evidence about the effectiveness and costs of a multifaceted implementation strategy to improve guideline adherence on TEM.TRIAL REGISTRATION: http://www.trialregister.nlNTR3405. This study is sponsored by ZonMW. |
Databáze: | OpenAIRE |
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