Evidence map›Paper›PMID 31053125›Full record

Trial reportBMC health services research2019

Effectiveness of a tailored implementation strategy to improve adherence to a guideline on mental health problems in occupational health care.

Margot C W Joosen, Karlijn M van Beurden, David S Rebergen, Monique A J M Loo, Berend Terluin, Jaap van Weeghel, Jac J L van der Klink, Evelien P M Brouwers

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
3.5field-weighted citation impact, top 8% of its field
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 14 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Margot C W JoosenTilburg University, Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Wellbeing, Tranzo, Postbus 90153, 5000, LE, Tilburg, The Netherlands. m.c.w.joosen@tilburguniversity.edu.ORCID http://orcid.org/0000-0001-5064-7302
Karlijn M van BeurdenTilburg University, Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Wellbeing, Tranzo, Postbus 90153, 5000, LE, Tilburg, The Netherlands.
David S RebergenShared Ambition, People Management, Amersfoort, The Netherlands.
Monique A J M LooM.A.J.M. Loo, Epe, The Netherlands.
Berend TerluinDepartment of General Practice and Elderly Care Medicine, VU University Medical Center Amsterdam, Amsterdam Public Health research institute, Amsterdam, The Netherlands.
Jaap van WeeghelTilburg University, Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Wellbeing, Tranzo, Postbus 90153, 5000, LE, Tilburg, The Netherlands.
Jac J L van der KlinkTilburg University, Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Wellbeing, Tranzo, Postbus 90153, 5000, LE, Tilburg, The Netherlands.
Evelien P M BrouwersTilburg University, Tilburg School of Social and Behavioral Sciences, Tranzo Scientific Center for Care and Wellbeing, Tranzo, Postbus 90153, 5000, LE, Tilburg, The Netherlands.
Tilburg University · NL

Funding

ZonMw 208030001
6 · The paper itself

Abstract

backgroundAs compliance to guidelines is generally low among health care providers, little is known about the impact of guidelines on the quality of delivery of care. To improve adherence to guideline recommendations on mental health problems, an implementation strategy was developed for Dutch occupational physicians (OPs). The aims were 1) to assess adherence to a mental health guideline in occupational health care and 2) to evaluate the effect of a tailored implementation strategy on guideline adherence compared to traditional guideline dissemination.

methodsAn audit of medical records was conducted as part of a larger RCT study. Participants were 66 OPs (32 intervention and 34 control) employed at one of six sites of an Occupational Health Service in southern Netherlands. OPs in the intervention group received multiple-session peer group training which focused on identifying and addressing barriers to using the guideline, using a Plan-Do-Check-Act approach. The control group did not receive training. Medical records of 114 workers sick-listed with mental health problems were assessed (56 intervention and 58 control). Guideline adherence was determined by auditing the records using 12 guideline-based performance indicators (PI), grouped into 5 PIs: process diagnosis, problem orientation, interventions/treatment, relapse prevention, and continuity of care. Differences in performance rates of the PIs between the intervention and control groups were analyzed, taking into account the cluster study design.

resultsOPs who received the training showed significantly greater adherence compared to the controls (p < .028) in 4 out of 5 grouped PIs, i.e. process diagnosis, problem orientation, interventions/treatment and relapse prevention. In one out of 12 PIs adherence was found adequate (53% of the medical records), in 6 PIs adherence was found minimal, and in 5 PIs the majority of the records showed no adherence.

conclusionsAn implementation strategy which addressed key barriers for change and tailor-made interventions improves adherence to an occupational health guideline for mental health problems compared to traditional guideline dissemination. However, adherence to the guideline recommendations is still far from optimal. To optimize adherence, it is recommended that implementation strategies focus on the workers level, organizational level, and the professional level.

trial registrationISRCTN86605310 . Registered 30 June 2010.

Indexed as

Occupational Health ServicesAdultAttitude of Health PersonnelFemaleGuideline AdherenceHealth PersonnelHumansMaleMental HealthMiddle AgedProgram EvaluationGuideline adherenceImplementationMental healthOccupational healthOccupational health professionalsOccupational medicinePractice guidelineWork disability prevention

Identifiers

PMID31053125
PMCPMC6499945
OpenAlexW2943115735

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.