Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/89283
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Type: | Journal article |
Title: | Improving the implementation of tailored expectant management in subfertile couples: Protocol for a cluster randomized trial |
Author: | van den Boogaard, N. Kersten, F. Goddijn, M. Bossuyt, P. van der Veen, F. Hompes, P. Hermens, R. Braat, D. Mol, B. Nelen, W. |
Citation: | Implementation Science, 2013; 8(53):1-7 |
Publisher: | BioMed Central Ltd |
Issue Date: | 2013 |
ISSN: | 1748-5908 1748-5908 |
Statement of Responsibility: | Noortje M van den Boogaard, Fleur AM Kersten, Mariëtte Goddijn, Patrick MM Bossuyt, Fulco van der Veen, Peter GA Hompes, Rosella PMG Hermens, Didi DM Braat, Ben Willem J Mol, Willianne LDM Nelen, and for the Improvement Study Group |
Abstract: | BACKGROUND 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. METHODS/DESIGN 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. DISCUSSION This study will provide evidence about the effectiveness and costs of a multifaceted implementation strategy to improve guideline adherence on TEM. TRIAL REGISTRATION http://www.trialregister.nl NTR3405. This study is sponsored by ZonMW. |
Keywords: | Improvement Study Group Humans Infertility, Male Infertility, Female Treatment Outcome Clinical Protocols Fertilization in Vitro Cluster Analysis Feedback Pamphlets Cost-Benefit Analysis Delivery of Health Care Guideline Adherence Medical Audit Netherlands Female Male Patient Education as Topic Practice Guidelines as Topic Watchful Waiting Outcome and Process Assessment, Health Care |
Rights: | © 2013 van den Boogaard et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
DOI: | 10.1186/1748-5908-8-53 |
Published version: | http://dx.doi.org/10.1186/1748-5908-8-53 |
Appears in Collections: | Aurora harvest 7 Paediatrics publications |
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hdl_89283.pdf | Published version | 273.19 kB | Adobe PDF | View/Open |
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