Evidence map›Paper›PMID 33980155›Full record

ArticleBMC family practice2021

Development of a complex intervention to improve mobility and participation of older people with vertigo, dizziness and balance disorders in primary care: a mixed methods study.

Verena Regauer, Eva Seckler, Eva Grill, Richard Ippisch, Klaus Jahn, Petra Bauer, Martin Müller

Open access · goldAbstract read
In one paragraph

Article in BMC family practice, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 28% 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, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Implementation science in care for older adults across healthcare settings: a scoping review.Archives of public health = Archives belges de sante publique · 2026
    Pooled it
  2. Article
  3. Article
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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

7 authors at 4 institutions in 2 countries.

Verena RegauerCentre for Research, Development and Technology Transfer, Rosenheim Technical University of Applied Sciences, Hochschulstraße 1, 83024, Rosenheim, Germany. verena.regauer@th-rosenheim.de.ORCID 0000-0002-6942-5790
Eva SecklerCentre for Research, Development and Technology Transfer, Rosenheim Technical University of Applied Sciences, Hochschulstraße 1, 83024, Rosenheim, Germany.
Eva GrillInstitute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilian University of Munich, Marchioninistraße 17, 81377, Munich, Germany.
Richard IppischPractice Centre Neurology, Psychiatry and Psychotherapy Germering, Josef-Kistler-Straße 10, 82110, Germering, Germany.
Klaus JahnGerman Centre for Vertigo and Balance Disorders, Ludwig-Maximilian University of Munich, Marchioninistrasse 15, 81377, Munich, Germany.
Petra BauerFaculty for Applied Health and Social Sciences, Development and Technology Transfer, Cen-Tre for Research, Rosenheim Technical University of Applied Sciences, Hochschulstraße 1, 83024, Rosenheim, Germany.
Martin MüllerFaculty for Applied Health and Social Sciences, Development and Technology Transfer, Cen-Tre for Research, Rosenheim Technical University of Applied Sciences, Hochschulstraße 1, 83024, Rosenheim, Germany.
Rosenheim Technical University of Applied Sciences · DEZimmer Biomet (Germany) · DESchön Klinik Bad Aibling · DEZimmer Biomet (Netherlands) · NL

Funding

Bayerisches Staatsministerium für Bildung und Kultus, Wissenschaft und Kunst Bavarian Academic Forum (BayWISS)Bundesministerium für Bildung und Forschung 01GY1603C
6 · The paper itself

Abstract

backgroundVertigo, dizziness and balance disorders (VDB) are common in older people and cause restrictions in mobility and social participation. Due to a multifactorial aetiology, health care is often overutilised, but many patients are also treated insufficiently in primary care. The purpose of this study was to develop a care pathway as a complex intervention to improve mobility and participation in older people with VDB in primary care.

methodsThe development process followed the UK Medical Research Council guidance using a mixed-methods design with individual and group interviews carried out with patients, physical therapists (PTs), general practitioners (GPs), nurses working in community care and a multi-professional expert panel to create a first draft of a care pathway (CPW) and implementation strategy using the Consolidated Framework of Implementation Research and the Expert recommendations for Implementing Change. Subsequently, small expert group modelling of specific components of the CPW was carried out, with GPs, medical specialists and PTs. The Behaviour Change Wheel was applied to design the intervention´s approach to behaviour change. To derive theoretical assumptions, we adopted Kellogg´s Logic Model to consolidate the hypothesized chain of causes leading to patient-relevant outcomes.

resultsIndividual interviews with patients showed that VDB symptoms need to be taken more seriously by GPs. Patients demanded age-specific treatment offers, group sessions or a continuous mentoring by a PT. GPs required a specific guideline for diagnostics and treatment options including psychosocial interventions. Specific assignment to and a standardized approach during physical therapy were desired by PTs. Nurses favoured a multi-professional documentation system. The structured three-day expert workshop resulted in a first draft of CPW and potential implementation strategies. Subsequent modelling resulted in a CPW with components and appropriate training materials for involved health professionals. A specific implementation strategy is now available.

conclusionA mixed-methods design was suggested to be a suitable approach to develop a complex intervention and its implementation strategy. We will subsequently test the intervention for its acceptability and feasibility in a feasibility study accompanied by a comprehensive process evaluation to inform a subsequent effectiveness trial.

trial registrationThe research project is registered in "Projektdatenbank Versorgungsforschung Deutschland" (Project-ID: VfD_MobilE-PHY_17_003910; date of registration: 30.11.2017).

Indexed as

DizzinessGeneral PractitionersAgedFeasibility StudiesHumansPrimary Health CareVertigoAgedCritical PathwaysDizzinessGeneral PractitionersImplementation SciencePhysical Therapy ModalitiesPrimary Health CareVertigo

Identifiers

PMID33980155
PMCPMC8117292
OpenAlexW3155495805

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.