ArticleBMJ open2024
Barriers to and facilitators of successful implementation of a palliative approach to care in primary care practices: a mixed methods study.
Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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Who cites it
4 citing papers in PubMed.
- A scoping review of palliative care assessment tools.BMC palliative care · 2026Article
- Reframing Emergency Medical Service in the context of chronic non-communicable disease and palliative care.African journal of primary health care & family medicine · 2026Article
- Mindfulness-based interventions for pain, anxiety, depression, and quality of life in patients receiving palliative care: a meta-analysis.Journal of research in nursing : JRN · 2026Article
- Evaluating the use of the consolidated framework for implementation research in primary care settings: a systematic review.Implementation science communications · 2026Review
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveIntegrating a palliative approach to care into primary care is an emerging evidence-based practice. Despite the evidence, this type of care has not been widely adopted into primary care settings. The objective of this study was to examine the barriers to and facilitators of successful implementation of a palliative approach to care in primary care practices by applying an implementation science framework.
designThis convergent mixed methods study analysed semistructured interviews and expression of interest forms to evaluate the implementation of a protocol, linked to implementation strategies, for a palliative approach to care called Early Palliation through Integrated Care (EPIC) in three primary care practices. This study assessed barriers to and facilitators of implementation of EPIC and was guided by the Consolidated Framework for Implementation Research (CFIR). A framework analysis approach was used during the study to determine the applicability of CFIR constructs and domains.
settingPrimary care practices in Canada. Interviews were conducted between September 2020 and November 2021.
participants10 individuals were interviewed, who were involved in implementing EPIC. Three individuals from each practice were reinterviewed to clarify emerging themes.
resultsOverall, there were implementation barriers at multiple levels that caused some practices to struggle. However, barriers were mitigated when practices had the following facilitators: (1) a high level of intra-practice collaboration, (2) established practices with organisational structures that enhanced communications, (3) effective leveraging of EPIC project supports to transition care, (4) perceptions that EPIC was an opportunity to make a long-term change in their approach to care as opposed to a limited term project and (5) strong practice champions.
conclusionsFuture implementation work should consider assessing facilitators identified in our results to better gauge primary care pre-implementation readiness. In addition, providing primary care practices with support to help offset the additional work of implementing innovations and networking opportunities where they can share strategies may improve implementation success.
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