Implementing targeted expectant management in fertility care using prognostic modelling: a cluster randomized trial with a multifaceted strategy

Kersten, Fleur A M; Nelen, W.L.D.M.; Boogaard, N.M. van den; Rumste, Minouche M. van; Koks, Carolien A.M.; IntHout, Joanna; Verhoeve, Harold R.; Pelinck, M. J.; Boks, Dominique E.S.; Gianotten, Judith; Broekmans, Frank J.; Goddijn, Mariëtte; Braat, D.D.M.; Mol, Ben Willem J.; Hermens, Rosella

doi:10.1093/humrep/dex213

Cited by 2 publications

(5 citation statements)

References 19 publications

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“…Various implementation planning approaches were used in complementary ways. Twelve of the included studies (10.2%) combined pre-identified barriers with tailoring of the intervention and stakeholder engagement [ 42 , 45 , 79 , 89 , 98 , 106 , 118 , 119 , 131 , 141 , 158 ]. Nine of the included studies (7.6%) employed a theory or framework, pre-identified barriers, and tailoring [ 48 , 56 , 62 , 67 , 68 , 70 , 86 , 114 , 134 ].…”

Section: Resultsmentioning

confidence: 99%

“…[ 42 , 49 , 52 , 58 , 59 , 62 , 65 , 72 – 74 , 80 , 89 , 94 , 99 , 103 , 106 , 108 , 110 , 112 – 115 , 119 , 120 , 125 , 128 – 130 , 132 – 134 , 137 , 139 , 143 , 144 , 150 – 153 , 155 ]…”

Section: Resultsunclassified

“…[ 43 , 51 , 54 , 57 , 62 , 63 , 71 , 72 , 78 , 83 , 85 , 97 , 102 , 105 , 106 , 111 , 116 , 118 , 120 , 123 , 128 , 133 , 139 , 142 , 152 , 156 ]…”

Section: Resultsunclassified

“…[ 45 , 46 , 50 , 51 , 57 , 65 , 78 , 85 , 98 , 99 , 105 , 106 , 108 , 111 , 119 , 128 , 132 , 143 , 159 ]…”

Section: Resultsunclassified

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Trends in guideline implementation: an updated scoping review

et al. 2022

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Background Guidelines aim to support evidence-informed practice but are inconsistently used without implementation strategies. Our prior scoping review revealed that guideline implementation interventions were not selected and tailored based on processes known to enhance guideline uptake and impact. The purpose of this study was to update the prior scoping review. Methods We searched MEDLINE, EMBASE, AMED, CINAHL, Scopus, and the Cochrane Database of Systematic Reviews for studies published from 2014 to January 2021 that evaluated guideline implementation interventions. We screened studies in triplicate and extracted data in duplicate. We reported study and intervention characteristics and studies that achieved impact with summary statistics. Results We included 118 studies that implemented guidelines on 16 clinical topics. With regard to implementation planning, 21% of studies referred to theories or frameworks, 50% pre-identified implementation barriers, and 36% engaged stakeholders in selecting or tailoring interventions. Studies that employed frameworks (n=25) most often used the theoretical domains framework (28%) or social cognitive theory (28%). Those that pre-identified barriers (n=59) most often consulted literature (60%). Those that engaged stakeholders (n=42) most often consulted healthcare professionals (79%). Common interventions included educating professionals about guidelines (44%) and information systems/technology (41%). Most studies employed multi-faceted interventions (75%). A total of 97 (82%) studies achieved impact (improvements in one or more reported outcomes) including 10 (40% of 25) studies that employed frameworks, 28 (47.45% of 59) studies that pre-identified barriers, 22 (52.38% of 42) studies that engaged stakeholders, and 21 (70% of 30) studies that employed single interventions. Conclusions Compared to our prior review, this review found that more studies used processes to select and tailor interventions, and a wider array of types of interventions across the Mazza taxonomy. Given that most studies achieved impact, this might reinforce the need for implementation planning. However, even studies that did not plan implementation achieved impact. Similarly, even single interventions achieved impact. Thus, a future systematic review based on this data is warranted to establish if the use of frameworks, barrier identification, stakeholder engagement, and multi-faceted interventions are associated with impact. Trial registration The protocol was registered with Open Science Framework (https://osf.io/4nxpr) and published in JBI Evidence Synthesis.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsunclassified

“…[ 43 , 51 , 54 , 57 , 62 , 63 , 71 , 72 , 78 , 83 , 85 , 97 , 102 , 105 , 106 , 111 , 116 , 118 , 120 , 123 , 128 , 133 , 139 , 142 , 152 , 156 ]…”

Section: Resultsunclassified

“…[ 45 , 46 , 50 , 51 , 57 , 65 , 78 , 85 , 98 , 99 , 105 , 106 , 108 , 111 , 119 , 128 , 132 , 143 , 159 ]…”

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Trends in guideline implementation: an updated scoping review

et al. 2022

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“…The scores of all subgroups were added together for each barrier, and a priority list was made. The top eight identified barriers were considered most important because of the feasibility of implementing adherent improvement strategies for a total of eight barriers in a multifaceted improvement strategy (Grimshaw et al 2012;Kersten et al 2017). These eight barriers and their associated improvement strategies were discussed with the entire expert panel as part of the development of a multifaceted programme, taking into account the improvement suggestions identified in part I.…”

Section: Part Ii: Selection Of Improvement Strategiesmentioning

confidence: 99%

Professionals’ barriers in female oncofertility care and strategies for improvement

et al. 2019

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What are healthcare professionals' barriers and strategies for improvement in female oncofertility care? SUMMARY ANSWER: Professionals perceived barriers in knowledge, attitude and organization of oncofertility care and suggested strategies to improve oncofertility care. WHAT IS KNOWN ALREADY: The potential loss of fertility is one of the most important undesirable side effects of cancer treatment in women of reproductive age. Unfortunately, despite guideline recommendations, not all patients are informed about their fertility risks and referred for fertility preservation (FP) counselling. Insight into barriers for discussing FP and appropriate referral is necessary before improvements can be made. STUDY DESIGN, SIZE, DURATION: The aim of this was study was to identify barriers and gather improvement suggestions through semi-structured in-depth interviews conducted with 24 professionals working in oncofertility care. Subsequently, an expert panel meeting was held to reach consensus on a set of improvement strategies. PARTICIPANTS/MATERIALS, SETTING, METHODS: Oncological professionals were recruited from the three Dutch expertise hospitals for female FP and their affiliated hospitals. The expert panel consisted of six healthcare professionals, five survivors and two researchers. In the Dutch setting, financial aspects do not play a role in oncofertility care. MAIN RESULTS AND THE ROLE OF CHANCE: Barriers were identified and categorized into the patient level (e.g. focus on surviving cancer), the professional level (e.g. lack of awareness, knowledge, time, and attitude), or the organizational level (e.g. unavailable written information, disagreement on who is responsible for discussing infertility risks). The expert panel reached consensus on essential elements for a multifaceted improvement programme: development of information materials (leaflets, online decision aid), education of professionals, a role for specialized oncology nurses in informing patients and patient navigators at the fertility department to facilitate referral and counselling, medical record reminders, standard consultations with a gynaecologist and agreement on responsibility. LIMITATIONS, REASONS FOR CAUTION: Selection bias could have occurred because it is likely that only professionals with interest in oncofertility care participated. However, this would mean that the barriers were underestimated. WIDER IMPLICATIONS OF THE FINDINGS: This study forms the basis for the development of a multifaceted oncofertility programme, which is essential to increase adherence to the national clinical guideline.

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Implementing targeted expectant management in fertility care using prognostic modelling: a cluster randomized trial with a multifaceted strategy

Abstract: 10 July 2012.

Cited by 2 publications

References 19 publications

Trends in guideline implementation: an updated scoping review

Trends in guideline implementation: an updated scoping review

Professionals’ barriers in female oncofertility care and strategies for improvement

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