ArticleBJGP open2018
Implementing change in primary care practice: lessons from a mixed-methods evaluation of a frailty initiative.
Article in BJGP open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
7 citing papers in PubMed.
- Barriers to implementation of STRIDE, a national study to prevent fall-related injuries.Journal of the American Geriatrics Society · 2021Trial
- Person-Centered Multimorbidity Care in UK Primary Care: Identifying Changes to Practice.Annals of family medicine · 2026Article
- The journey to a learning health system in primary care: a qualitative case study utilising an embedded research approach.BMC primary care · 2023Article
- A Rapid Realist Review of Quality Care Process Metrics Implementation in Nursing and Midwifery Practice.International journal of environmental research and public health · 2021Article
- Advance care planning conversations in primary care: a quality improvement project using the Serious Illness Care Program.BMC palliative care · 2021Article
- Implementation of a first-trimester prognostic model to improve screening for gestational diabetes mellitus.BMC pregnancy and childbirth · 2021Article
- Redesigning primary care in an academic medical center: lessons, challenges, and opportunities.Postgraduate medicine · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe NHS is facing increasing needs from an aging population, which is acutely visible in the emerging problem of frailty. There is growing evidence describing new models of care for people living with frailty, but a lack of evidence on successful implementation of these complex interventions at the practice level.
aimThis study aimed to determine what factors enable or prevent implementation of a whole-system, complex intervention for managing frailty (the PACT initiative) in the UK primary care setting. DESIGN &
settingA mixed-methods evaluation study undertaken within a large clinical commissioning group (CCG). Design and analysis was informed by normalisation process theory (NPT).
methodData collection from six sites included: observation of delivery, interviews with staff, and an online survey. NPT-informed analysis sought to identify enablers and barriers to implementation of change.
resultsSeven themes were identified. PACT was valued by professionals and patients but a lack of clarity on its aims was identified as a barrier to implementation. Successful implementation relied on champions pushing the work forward, and dealing with unanticipated resistance. Contracts focused on delivery of service outcomes, but these were sometimes at odds with professional priorities. Implementation followed evidence-informed rather than evidence-based practice, requiring redesign of the intervention and potentially created a new body of knowledge on managing frailty.
conclusionSuccessful implementation of complex interventions in primary care need inbuilt capacity for flexibility and adaptability, requiring expertise as well as evidence. Professionals need to be supported to translate innovative practice into practice-based evidence.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.