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Tricco AC, Moore JE, Beben N, Brownson RC, Chambers DA, Dolovich LR, Edwards A, Fairclough L, Glasziou PP, Graham ID, Hemmelgarn BR, Holmes B, Isaranuwatchai W, Lachance CC, Legare F, McGowan J, Majumdar SR, Presseau J, Squires JE, Stelfox HT, Strifler L, Thompson K, Van der Weijden T, Veroniki AA, Straus SE. Sustaining knowledge translation interventions for chronic disease management in older adults: protocol for a systematic review and network meta-analysis. Syst Rev 2018; 7:140. [PMID: 30219107 PMCID: PMC6138921 DOI: 10.1186/s13643-018-0808-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 09/02/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Failure to sustain knowledge translation (KT) interventions impacts patients and health systems, diminishing confidence in future implementation. Sustaining KT interventions used to implement chronic disease management (CDM) interventions is of critical importance given the proportion of older adults with chronic diseases and their need for ongoing care. Our objectives are to (1) complete a systematic review and network meta-analysis of the effectiveness and cost-effectiveness of sustainability of KT interventions that target CDM for end-users including older patients, clinicians, public health officials, health services managers and policy-makers on health care outcomes beyond 1 year after implementation or the termination of initial project funding and (2) use the results of this review to complete an economic analysis of the interventions identified to be effective. METHODS For objective 1, comprehensive searches of relevant electronic databases (e.g. MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials), websites of health care provider organisations and funding agencies will be conducted. We will include randomised controlled trials (RCTs) examining the impact of a KT intervention targeting CDM in adults aged 65 years and older. To examine cost, economic studies (e.g. cost, cost-effectiveness analyses) will be included. Our primary outcome will be the sustainability of the delivery of the KT intervention beyond 1 year after implementation or termination of study funding. Secondary outcomes will include behaviour changes at the level of the patient (e.g. symptom management) and clinician (e.g. physician test ordering) and health system (e.g. cost, hospital admissions). Article screening, data abstraction and risk of bias assessment will be completed independently by two reviewers. Using established methods, if the assumption of transitivity is valid and the evidence forms a connected network, Bayesian random-effects pairwise and network meta-analysis will be conducted. For objective 2, we will build a decision analytic model comparing effective interventions to estimate an incremental cost-effectiveness ratio. DISCUSSION Our results will inform knowledge users (e.g. patients, clinicians, policy-makers) regarding the sustainability of KT interventions for CDM. Dissemination plan of our results will be tailored to end-users and include passive (e.g. publications, website posting) and interactive (e.g. knowledge exchange events with stakeholders) strategies. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42018084810.
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Affiliation(s)
- Andrea C. Tricco
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Knowledge Translation Program, 209 Victoria Street, East Building, Room 716, Toronto, Ontario M5B 1W8 Canada
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, Ontario M5T 3M7 Canada
| | - Julia E. Moore
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Knowledge Translation Program, 209 Victoria Street, East Building, Room 716, Toronto, Ontario M5B 1W8 Canada
| | - Nicole Beben
- Canadian Partnership Against Cancer, 1 University Avenue, Suite 300, Toronto, Ontario M5J 2P1 Canada
| | - Ross C. Brownson
- Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, MO 63130 USA
- Department of Surgery and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, 660 S. Euclid Avenue, St. Louis, MO 63110 USA
| | - David A. Chambers
- National Cancer Institute, 9609 Medical Center Drive, Room 3E414, Rockville, MD 20850 USA
| | - Lisa R. Dolovich
- Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College Street, Room 607, Toronto, Ontario M5S 3M2 Canada
- Department of Family Medicine David Braley Health Sciences Centre, McMaster University, 100 Main Street West, 5th floor, Hamilton, Ontario L8P 1H6 Canada
| | - Annemarie Edwards
- Canadian Partnership Against Cancer, 1 University Avenue, Suite 300, Toronto, Ontario M5J 2P1 Canada
| | - Lee Fairclough
- Health Quality Ontario, 130 Bloor Street West, 10th floor, Toronto, Ontario M5S 1N5 Canada
| | - Paul P. Glasziou
- Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland 4226 Australia
| | - Ian D. Graham
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, K1G 5Z3 Canada
- The Ottawa Hospital Research Institute, 501 Smyth Road, Box 711, Ottawa, Ontario K1H 8L6 Canada
| | - Brenda R. Hemmelgarn
- Departments of Medicine and Community Health Sciences, University of Calgary, TRW Building, 3rd Floor, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6 Canada
| | - Bev Holmes
- The Michael Smith Foundation for Health Research (MSFHR), 200 - 1285 West Broadway, Vancouver, British Columbia V6H 3X8 Canada
| | - Wanrudee Isaranuwatchai
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Knowledge Translation Program, 209 Victoria Street, East Building, Room 716, Toronto, Ontario M5B 1W8 Canada
| | - Chantelle C. Lachance
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Knowledge Translation Program, 209 Victoria Street, East Building, Room 716, Toronto, Ontario M5B 1W8 Canada
| | - France Legare
- Département de Médecine Sociale et Préventive, Faculté de médecine, Université Laval Pavillon Ferdinand-Vandry1050, avenue de la Médecine, local 2431, Québec, Québec G1V 0A6 Canada
- Axe Santé des Populations et Pratiques Optimales en Santé, Centre de Recherche du CHU de Québec, 1050, chemin Sainte-Foy, local K0-03, Québec, Québec G1S 4L8 Canada
| | - Jessie McGowan
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, K1G 5Z3 Canada
| | - Sumit R. Majumdar
- Department of Medicine, University of Alberta, 13-103 Clinical Sciences Building, 11350-83 Avenue, Edmonton, Alberta T6G 2G3 Canada
| | - Justin Presseau
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, K1G 5Z3 Canada
- The Ottawa Hospital Research Institute, 501 Smyth Road, Box 711, Ottawa, Ontario K1H 8L6 Canada
| | - Janet E. Squires
- School of Epidemiology and Public Health, University of Ottawa, 600 Peter Morand Crescent, Ottawa, K1G 5Z3 Canada
- School of Nursing, University of Ottawa, 451 Smyth Road, Ottawa, Ontario K1H 8M5 Canada
| | - Henry T. Stelfox
- Departments of Critical Care Medicine, Medicine and Community Health Sciences, University of Calgary, 2500 University Drive NW, Calgary, Alberta T2N 1N4 Canada
| | - Lisa Strifler
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Knowledge Translation Program, 209 Victoria Street, East Building, Room 716, Toronto, Ontario M5B 1W8 Canada
| | - Kristine Thompson
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Knowledge Translation Program, 209 Victoria Street, East Building, Room 716, Toronto, Ontario M5B 1W8 Canada
| | - Trudy Van der Weijden
- Department of Family Medicine, Maastricht University, CAPHRI Care and Public Health Research Institute, Universiteitssingel 40, 6229 ER Maastricht, The Netherlands
| | - Areti Angeliki Veroniki
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Knowledge Translation Program, 209 Victoria Street, East Building, Room 716, Toronto, Ontario M5B 1W8 Canada
| | - Sharon E. Straus
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Knowledge Translation Program, 209 Victoria Street, East Building, Room 716, Toronto, Ontario M5B 1W8 Canada
- Department of Geriatric Medicine, University of Toronto, 27 Kings College Circle, Toronto, Ontario M5S 1A1 Canada
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