Including Economic Evaluations in Implementation Science

Yoon, Jean

doi:10.1007/s11606-020-05649-w

Cited by 5 publications

(5 citation statements)

References 15 publications

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“…Studies on the cost-effectiveness of the STarT-Back-Approach indicate that a reduction of costs is possible, 13,14 and, from a socio-economic perspective, this is an important facilitator for its implementation. 56,57 However, costs are not only cut, but reallocated from low- to high-risk patients. 19 This means more intensive and costlier treatments are recommended only for those at high risk and not for patients whose pain is likely to be self-limiting.…”

Section: Discussionmentioning

confidence: 99%

Patients’ Views on the Implementation Potential of a Stratified Treatment Approach for Low Back Pain in Germany: A Qualitative Study

Karstens

Lang

Saunders

2020

Health�Serv�Insights

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Stratified care for low back pain (LBP) has been shown to be clinically- and cost-effective in the UK, but its transferability to the German healthcare system is unknown. This study explores LBP patients’ perspectives regarding future implementation of stratified care, through in-depth interviews (n = 12). The STarT-Back-Tool was completed by participants prior to interviews. Interview data were analysed using Grounded Theory. The overarching theme identified from the data was ‘treatment-success’, with subthemes of ‘assessment and treatment planning’, ‘acceptance of the questionnaire’ and ‘contextual factors’. Patients identified the underlying cause of pain as being of great importance (whereas STarT-Back allocates treatment based on prognosis). The integration of the STarT-Back-Tool in consultations was considered helpful as long as it does not disrupt the therapeutic relationship, and was acceptable if tool results are handled confidentially. Results indicate that for patients to find STarT-Back acceptable, the shift from a focus on identifying a cause of pain and subsequent diagnosis, to prediction-orientated treatment planning, must be made clear. Patient ‘buy in’ is important for successful uptake of clinical interventions, and findings can help to inform future strategies for implementing STarT-Back in the Germany, as well as having potential implications for transferability to other similar healthcare systems.

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Section: Discussionmentioning

confidence: 99%

Patients’ Views on the Implementation Potential of a Stratified Treatment Approach for Low Back Pain in Germany: A Qualitative Study

Karstens

Lang

Saunders

2020

Health�Serv�Insights

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“…54 Economic evaluation is particularly important for organizations and insurers, to enable appropriate resourcing. 55 Validated measures should be used for measuring these process outcomes where available. A systematic review of tools to measure process outcomes demonstrated significant heterogeneity between the tools, and these limitations should be considered when selecting measures.…”

Section: Defined Outcomes and Evaluationmentioning

confidence: 99%

What Are Models of Care? A Systematic Search and Narrative Review to Guide Development of Care Models for Premature Ovarian Insufficiency

et al. 2020

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No specific model of care (MoC) is recommended for premature ovarian insufficiency (POI), despite awareness that POI is associated with comorbidities requiring multidisciplinary care. This article aims to explore the definitions and central components of MoC in health settings, so that care models for POI can be developed. A systematic search was performed on Ovid Medline and Embase, and including gray literature. Unique definitions of MoC were identified, and thematic analysis was used to summarize the key component of MoC. Of 2,477 articles identified, 8 provided unique definitions of MoC, and 11 described components of MoC. Definitions differ in scope, focusing on disease, service, or system level, but a key feature is that MoC is operational, describing how care is delivered, as well as what that care is. Thematic analysis identified 42 components of MoC, summarized into 6 themes—stakeholder engagement, supporting integrated care, evidence-based care, defined outcomes and evaluation, behavior change methodology, and adaptability. Stakeholder engagement was central to all other themes. MoCs operationalize how best practice care can be delivered at a disease, service, or systems level. Specific MoC should be developed for POI, to improve clinical and process outcomes, translate evidence into practice, and use resources more efficiently.

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“…As implementation facilitation has become increasingly embraced as a strategy for implementing innovations into practice ( McCormack et al, 2021 ; Moore et al, 2020 ), there is heightened interest in examining the time allocated to implementation facilitation ( Edelman et al, 2020 ). This interest is heavily fueled by growing demands to better estimate the cost of implementation ( Yoon, 2020 ), and to adequately plan for resource allocation that can sufficiently support both the spread and sustainability of implemented practices ( Hunter et al, 2020 ). The burden of measurement and documentation is considerable, however, when it comes to collecting data continuously throughout an implementation effort ( Ritchie et al, 2020b ), especially when it involves multifaceted strategies such as implementation facilitation.…”

Section: Discussionmentioning

confidence: 99%

“…Time–motion methodology is beginning to be more widely used for implementation science. Especially as economic evaluation of implementation is receiving increased attention within the field (since implementation cost can influence whether and how to implement an evidence-based intervention) ( Eisman et al, 2020 ; Yoon, 2020 ), time–motion methodology is being embraced as an approach for collecting and analyzing data that inform implementation cost ( Matthieu et al, 2020 ; Lamper et al, 2020 ; Pittman et al, 2021 ). Notably, Ritchie et al (2020b) conducted a by-week time–motion study of implementation facilitation activities for the EFs, internal facilitators, and participating staff across all levels of the health care systems in which implementation of integrated mental health services within primary care settings was being carried out.…”

mentioning

confidence: 99%

Time–motion analysis of external facilitation for implementing the Collaborative Chronic Care Model in general mental health clinics: Use of an interval-based data collection approach

Kim

Miller

Ritchie

et al. 2022

Implementation Research and Practice

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Background: Facilitation is an effective strategy to implement evidence-based practices, often involving external facilitators (EFs) bringing content expertise to implementation sites. Estimating time spent on multifaceted EF activities is complex. Furthermore, collecting continuous time–motion data for facilitation tasks is challenging. However, organizations need this information to allocate implementation resources to sites. Thus, our objectives were to conduct a time–motion analysis of external facilitation, and compare continuous versus noncontinuous approaches to collecting time–motion data. Methods: We analyzed EF time–motion data from six VA mental health clinics implementing the evidence-based Collaborative Chronic Care Model (CCM). We documented EF activities during pre-implementation (4–6 weeks) and implementation (12 months) phases. We collected continuous data during the pre-implementation phase, followed by data collection over a 2-week period (henceforth, “a two-week interval”) at each of three time points (beginning/middle/end) during the implementation phase. As a validity check, we assessed how closely interval data represented continuous data collected throughout implementation for two of the sites. Results: EFs spent 21.8 ± 4.5 h/site during pre-implementation off-site, then 27.5 ± 4.6 h/site site-visiting to initiate implementation. Based on the 2-week interval data, EFs spent 2.5 ± 0.8, 1.4 ± 0.6, and 1.2 ± 0.6 h/week toward the implementation’s beginning, middle, and end, respectively. Prevalent activities were preparation/planning, process monitoring, program adaptation, problem identification, and problem-solving. Across all activities, 73.6% of EF time involved email, phone, or video communication. For the two continuous data sites, computed weekly time averages toward the implementation’s beginning, middle, and end differed from the interval data’s averages by 1.0, 0.1, and 0.2 h, respectively. Activities inconsistently captured in the interval data included irregular assessment, stakeholder engagement, and network development. Conclusions: Time–motion analysis of CCM implementation showed initial higher-intensity EF involvement that tapered. The 2-week interval data collection approach, if accounting for its potential underestimation of irregular activities, may be promising/efficient for implementation studies collecting time–motion data.

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Including Economic Evaluations in Implementation Science

Cited by 5 publications

References 15 publications

Patients’ Views on the Implementation Potential of a Stratified Treatment Approach for Low Back Pain in Germany: A Qualitative Study

Patients’ Views on the Implementation Potential of a Stratified Treatment Approach for Low Back Pain in Germany: A Qualitative Study

What Are Models of Care? A Systematic Search and Narrative Review to Guide Development of Care Models for Premature Ovarian Insufficiency

Time–motion analysis of external facilitation for implementing the Collaborative Chronic Care Model in general mental health clinics: Use of an interval-based data collection approach

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