Unravelling complex primary care programmes to maintain independent living in older people: a systematic overview

L C Smit, M J Schuurmans, J W Blom, I N Fabbricotti, A P D Jansen, G I J M Kempen, R Koopmans, W M Looman, R J F Melis, S F Metzelthin, E P Moll van Charante, M E Muntinga, F G H Ruikes, S L W Spoorenberg, J J Suijker, K Wynia, J Gussekloo, N J De Wit, N Bleijenberg

Research output: Contribution to journalMeeting AbstractAcademic

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OBJECTIVE: Complex interventions are criticized for being a 'black box', which makes it difficult to determine why they succeed or fail. Recently, nine proactive primary care programmes aiming to prevent functional decline in older adults showed inconclusive effects. The aim of this study was to systematically unravel, compare and synthesize the development and evaluation of nine primary care programs within a controlled trial to further improve the development and evaluation of complex interventions.

STUDY DESIGN AND SETTING: A systematic overview of all written data on the nine proactive primary care programmes was conducted using a validated item list. The nine proactive primary care programmes involved 214 general practices throughout the Netherlands.

RESULTS: There was little or no focus on the 1) context surrounding the care programme, 2) modelling of processes and outcomes, 3) intervention fidelity and adaptation, and 4) content and evaluation of training for interventionists.

CONCLUSIONS: An in-depth analysis of the context, modelling of the processes and outcomes, measurement and reporting of intervention fidelity, and implementation of effective training for interventionists is needed to enhance the development and replication of future complex interventions.

Original languageEnglish
Pages (from-to)110-119
Number of pages10
JournalJournal of clinical epidemiology
Issue numberApril
Early online date28 Dec 2017
Publication statusPublished - 1 Apr 2018


  • Journal Article

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