Evidence map›Paper›PMID 39443884›Full record

ArticleBMC primary care2024

What helps or hinders intervention success in primary care? Qualitative findings with older adults and primary care practitioners during a feasibility study to address malnutrition risk.

Liz Payne, Elisabeth Grey, Michelle Sutcliffe, Sue Green, Caroline Childs, Sian Robinson, Bernard Gudgin, Pam Holloway, Jo Kelly, Jackie Seely and 7 more

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In one paragraph

Article in BMC primary care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

17 authors.

Liz PayneSchool of Psychology, University of Southampton, Southampton, UK. E.A.Payne@soton.ac.uk.
Elisabeth GreyThe National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
Michelle SutcliffeDietetics Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
Sue GreenDepartment of Nursing Science, Bournemouth University, Bournemouth, UK.
Caroline ChildsHuman Development and Health, University of Southampton, Southampton, UK.
Sian RobinsonAGE Research Group, Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK.
Bernard GudginPublic and Patient Involvement, University of Southampton, Southampton, UK.
Pam HollowayPublic and Patient Involvement, University of Southampton, Southampton, UK.
Jo KellyPrimary Care Population Sciences and Medical Education, University of Southampton, Southampton, UK.
Jackie SeelyPrimary Care Population Sciences and Medical Education, University of Southampton, Southampton, UK.
Rebekah Le FeuvrePrimary Care Population Sciences and Medical Education, University of Southampton, Southampton, UK.
Paul AveyardNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Paramjit GillWarwick Medical School, University of Warwick, Warwick, UK.
Mike StroudClinical Nutrition, University of Southampton, Southampton, UK.
Paul LittlePrimary Care Population Sciences and Medical Education, University of Southampton, Southampton, UK.
Yardley LucySchool of Psychological Science, University of Bristol, Bristol, UK.
Leanne MorrisonSchool of Psychology, University of Southampton, Southampton, UK.

Funding

NIHR Programme Grant for Applied Research RP-PG-0614-20004
6 · The paper itself

Abstract

backgroundIn the UK, about 14% of community-dwelling adults aged 65 and over are estimated to be at risk of malnutrition. Screening older adults in primary care and treating those identified as 'at risk' may help reduce malnutrition risk and associated healthcare use, and improve quality of life. The aim of this study is to explore how primary care practitioners (PCPs) and older adults perceive, use and respond to an intervention to support those identified as 'at risk'.

methodsWe developed and optimised an intervention (screen and treat protocol, online tools and printed materials) to support primary care practitioners to identify malnutrition risk among older adults, and intervene where necessary. We recruited older adults (described as 'patients' here) taking part in a feasibility study, and carried out semi-structured interviews to assess PCPs' and patients' engagement with the intervention, and identify any contextual issues that supported or undermined their engagement.

resultsFour themes were developed, encompassing patients' and PCPs' perceptions of undernutrition, study measures and appointments, constraints on PCPs' enthusiasm to make a difference, and patients' expectations of nutritional appointments. Key findings included patients commonly not accepting advice for undernutrition/malnutrition but welcoming support for their nutritional needs; checklists potentially distracting patients from recalling discussions about their nutritional needs; a tension between PCPs' desire to recruit less-well patients and logistical difficulties in doing so; and patients compromising their nutritional needs to suit others.

conclusionsDiverse factors influence whether an intervention succeeds in primary care. PCPs learn about an intervention/study in different ways, vary in how they understand and accept its aims, and desire to make a difference to their patients. Patients bring perceptions and expectations about the study's aims, coloured by their habits and preferences, prior experience of research and healthcare, and pressure from social expectations. Each aspect must be considered when developing a successful primary care intervention that is viewed as relevant and meaningful, and presented using language that aligns with participants' values and goals. Our findings suggest that references to 'malnutrition risk' should be avoided in any patient-facing materials/interactions as participants do not accept or identify with this label.

Indexed as

Feasibility StudiesMalnutritionPrimary Health CareQualitative ResearchAgedAged, 80 and overAttitude of Health PersonnelFemaleHumansMalePhysicians, Primary CareUnited KingdomAgeingDietary supplementsEating patternsFeasibility studyGeneral practiceHealth services for the agedIndependent livingMalnutritionPerson-based ApproachPrimary health care

Identifiers

PMID39443884
PMCPMC11515772

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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.