PDF(Pubmed)
Abstract：
BACKGROUND: /Aims De-implementation, including the removal or reduction of unnecessary or inappropriate prescribing, is crucial to ensure patients receive appropriate evidence-based health care. The utilization of de-implementation efforts is contingent on the quality of strategy reporting. To further understand effective ways to de-implement medical practices, specification of behavioural targets and components of de-implementation strategies are required. This paper aims to critically analyse how well the behavioural targets and strategy components, in studies that focused on de-implementing unnecessary or inappropriate prescribing in secondary healthcare settings, were reported.
METHODS: A supplementary analysis of studies included in a recently published review of de-implementation studies was conducted. Article text was coded verbatim to two established specification frameworks. Behavioural components were coded deductively to the five elements of the Action, Actor, Context, Target, Time (AACTT) framework. Strategy components were mapped to the nine elements of the Proctor\'s \'measuring implementation strategies\' framework.
RESULTS: The behavioural components of low-value prescribing, as coded to the AACTT framework, were generally specified well. However, the Actor and Time components were often vague or not well reported. Specification of strategy components, as coded to the Proctor framework, were less well reported. Proctor\'s Actor, Action target: specifying targets, Dose and Justification elements were not well reported or varied in the amount of detail offered. We also offer suggestions of additional specifications to make, such as the \'interactions\' participants have with a strategy.
CONCLUSIONS: Specification of behavioural targets and components of de-implementation strategies for prescribing practices can be accommodated by the AACTT and Proctor frameworks when used in conjunction. These essential details are required to understand, replicate and successfully de-implement unnecessary or inappropriate prescribing. In general, standardisation in the reporting quality of these components is required to replicate any de-implementation efforts.
BACKGROUND: Not registered.
METHODS: A supplementary analysis of studies included in a recently published review of de-implementation studies was conducted. Article text was coded verbatim to two established specification frameworks. Behavioural components were coded deductively to the five elements of the Action, Actor, Context, Target, Time (AACTT) framework. Strategy components were mapped to the nine elements of the Proctor\'s \'measuring implementation strategies\' framework.
RESULTS: The behavioural components of low-value prescribing, as coded to the AACTT framework, were generally specified well. However, the Actor and Time components were often vague or not well reported. Specification of strategy components, as coded to the Proctor framework, were less well reported. Proctor\'s Actor, Action target: specifying targets, Dose and Justification elements were not well reported or varied in the amount of detail offered. We also offer suggestions of additional specifications to make, such as the \'interactions\' participants have with a strategy.
CONCLUSIONS: Specification of behavioural targets and components of de-implementation strategies for prescribing practices can be accommodated by the AACTT and Proctor frameworks when used in conjunction. These essential details are required to understand, replicate and successfully de-implement unnecessary or inappropriate prescribing. In general, standardisation in the reporting quality of these components is required to replicate any de-implementation efforts.
BACKGROUND: Not registered.
摘要：
背景：/目标取消实施，包括删除或减少不必要或不适当的处方，对于确保患者获得适当的循证医疗保健至关重要。取消执行工作的利用取决于战略报告的质量。为了进一步了解取消医疗实践的有效方法，需要规范行为目标和取消实施战略的组成部分。本文旨在批判性地分析行为目标和战略组成部分的好坏，在专注于在二级医疗保健环境中取消不必要或不适当处方的研究中，被报道。
方法：对最近发表的取消实施研究综述中的研究进行了补充分析。文章文本被逐字编码到两个既定的规范框架中。行为成分被演绎地编码为行动的五个要素，演员,上下文,目标,时间（AACTT）框架。战略组件被映射到Proctor的“衡量实施战略”框架的九个元素。
结果：低价值处方的行为成分，编码到AACTT框架中，一般规定得很好。然而,Actor和Time组件通常含糊不清或没有很好地报告。战略组成部分的规范，编码到Proctor框架中，报道得不太好。Proctor\的演员,行动目标:指定目标,剂量和理由要素没有很好地报告或在提供的细节数量上有所变化。我们还提供其他规格的建议，例如“互动”参与者有一个策略。
结论：AACTT和Proctor框架联合使用时，可以适应处方实践的行为目标和取消实施策略的组成部分的规范。这些基本细节需要理解，复制并成功取消不必要或不适当的处方。总的来说,这些组件的报告质量标准化是重复任何取消实施工作所必需的。
背景：未注册。
方法：对最近发表的取消实施研究综述中的研究进行了补充分析。文章文本被逐字编码到两个既定的规范框架中。行为成分被演绎地编码为行动的五个要素，演员,上下文,目标,时间（AACTT）框架。战略组件被映射到Proctor的“衡量实施战略”框架的九个元素。
结果：低价值处方的行为成分，编码到AACTT框架中，一般规定得很好。然而,Actor和Time组件通常含糊不清或没有很好地报告。战略组成部分的规范，编码到Proctor框架中，报道得不太好。Proctor\的演员,行动目标:指定目标,剂量和理由要素没有很好地报告或在提供的细节数量上有所变化。我们还提供其他规格的建议，例如“互动”参与者有一个策略。
结论：AACTT和Proctor框架联合使用时，可以适应处方实践的行为目标和取消实施策略的组成部分的规范。这些基本细节需要理解，复制并成功取消不必要或不适当的处方。总的来说,这些组件的报告质量标准化是重复任何取消实施工作所必需的。
背景：未注册。
