TY - JOUR
T1 - Improving the implementation of tailored expectant management in subfertile couples: protocol for a cluster randomized trial
AU - van den Boogaard, Noortje M.
AU - Kersten, Fleur A. M.
AU - Goddijn, Mariette
AU - Bossuyt, Patrick M. M.
AU - van der Veen, Fulco
AU - Hompes, Peter G. A.
AU - Hermens, Rosella P. M. G.
AU - Braat, Didi D. M.
AU - Mol, Ben Willem J.
AU - Nelen, Willianne L. D. M.
AU - AUTHOR GROUP
AU - Kersten, Fleur
AU - Hompes, Peter
AU - Hermens, Rosella
AU - Braat, Didi
AU - Nelen, Willianne
AU - Verhoeve, Harold
AU - Gianotten, Judith
AU - de Bruin, Jan Peter
AU - de Koning, Corry
AU - Koks, Carolien
AU - Broekmans, Frank
AU - Zoet, Gerbrand
AU - Muijsers, Guido
AU - Kwee, Janet
AU - Scheffer-Nijsen, Gabrielle
AU - van Rijn, Janne Meije
AU - Hoek, Annemieke
AU - Pelinck, Marie-Jose
AU - van Rooy, Ilse
AU - Spinder, Taeke
AU - Sluijmer, Alexander
AU - van Rumste, Minouche
AU - Boks, Dominique
AU - Vollebergh, Jos
AU - Tepe, Eveline
AU - Scheenjes, Eduard
AU - Kuchenbecker, Walter
AU - van der Ploeg, Jacobien
PY - 2013
Y1 - 2013
N2 - Prognostic models in reproductive medicine can help to identify subfertile couples who would benefit from fertility treatment. Expectant management in couples with a good chance of natural conception, i.e., tailored expectant management (TEM), prevents unnecessary treatment and is therefore recommended in international fertility guidelines. However, current implementation is not optimal, leaving room for improvement. Based on barriers and facilitators for TEM that were recently identified among professionals and subfertile couples, we have developed a multifaceted implementation strategy. The goal of this study is to assess the effects of this implementation strategy on the guideline adherence on TEM. In a cluster randomized trial, 25 clinics and their allied practitioners units will be randomized between the multifaceted implementation strategy and care as usual. Randomization will be stratified for in vitro fertilization (IVF) facilities (full licensed, intermediate/no IVF facilities). The effect of the implementation strategy, i.e., the percentage guideline adherence on TEM, will be evaluated by pre- and post-randomization data collection. Furthermore, there will be a process and cost evaluation of the strategy. The implementation strategy will focus on subfertile couples and their care providers i.e., general practitioners (GPs), fertility doctors, and gynecologists. The implementation strategy addresses three levels: patient level: education materials in the form of a patient information leaflet and a website; professional level: audit and feedback, educational outreach visit, communication training, and access to a digital version of the prognostic model of Hunault on a website; organizational level: providing a protocol based on the guideline. The primary outcome will be the percentage guideline adherence on TEM. Additional outcome measures will be treatment-, patient-, and process-related outcome measures. This study will provide evidence about the effectiveness and costs of a multifaceted implementation strategy to improve guideline adherence on TEM. http://www.trialregister.nlNTR3405. This study is sponsored by ZonMW
AB - Prognostic models in reproductive medicine can help to identify subfertile couples who would benefit from fertility treatment. Expectant management in couples with a good chance of natural conception, i.e., tailored expectant management (TEM), prevents unnecessary treatment and is therefore recommended in international fertility guidelines. However, current implementation is not optimal, leaving room for improvement. Based on barriers and facilitators for TEM that were recently identified among professionals and subfertile couples, we have developed a multifaceted implementation strategy. The goal of this study is to assess the effects of this implementation strategy on the guideline adherence on TEM. In a cluster randomized trial, 25 clinics and their allied practitioners units will be randomized between the multifaceted implementation strategy and care as usual. Randomization will be stratified for in vitro fertilization (IVF) facilities (full licensed, intermediate/no IVF facilities). The effect of the implementation strategy, i.e., the percentage guideline adherence on TEM, will be evaluated by pre- and post-randomization data collection. Furthermore, there will be a process and cost evaluation of the strategy. The implementation strategy will focus on subfertile couples and their care providers i.e., general practitioners (GPs), fertility doctors, and gynecologists. The implementation strategy addresses three levels: patient level: education materials in the form of a patient information leaflet and a website; professional level: audit and feedback, educational outreach visit, communication training, and access to a digital version of the prognostic model of Hunault on a website; organizational level: providing a protocol based on the guideline. The primary outcome will be the percentage guideline adherence on TEM. Additional outcome measures will be treatment-, patient-, and process-related outcome measures. This study will provide evidence about the effectiveness and costs of a multifaceted implementation strategy to improve guideline adherence on TEM. http://www.trialregister.nlNTR3405. This study is sponsored by ZonMW
U2 - https://doi.org/10.1186/1748-5908-8-53
DO - https://doi.org/10.1186/1748-5908-8-53
M3 - Article
C2 - 23688282
SN - 1748-5908
VL - 8
SP - 53
JO - IMPLEMENTATION SCIENCE
JF - IMPLEMENTATION SCIENCE
IS - 1
M1 - 53
ER -